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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-10192023-093431


Thesis type
Tesi di specializzazione (4 anni)
Author
LA ROCCA, GAETANO
URN
etd-10192023-093431
Thesis title
Primary Sjögren's Syndrome-related Interstitial Lung Disease, a monocentric experience
Department
MEDICINA CLINICA E SPERIMENTALE
Course of study
REUMATOLOGIA
Supervisors
relatore Prof.ssa Baldini, Chiara
relatore Prof.ssa Mosca, Marta
Keywords
  • Sjögren
  • lung
  • ILD
  • phenotypes
  • outcome
  • progression
Graduation session start date
06/11/2023
Availability
Withheld
Release date
06/11/2093
Summary
Lung involvement is among the most frequent extraglandular manifestations of Primary Sjogren’s Syndrome (pSS). Interstitial Lung Disease (ILD) presence is clearly associated with increased mortality and usually drives therapeutic choices. Indeed, lung involvement in pSS patients is a very complex phenomenon resulting from the potential combination of at least 3 pathophysiological mechanisms: bronchial disease, interstitial lung changes and lymphoproliferative manifestations.
In this complex scenario, this thesis addresses the phenotypic and prognostic stratification of pSS-ILD patients, representing a very actual challenge for the modern rheumatologist. Chapter 1 provides a brief introduction and outline of the thesis.
In Chapter 2 an extensive review of the literature highlights the many open questions and discusses the most controversial aspects in the field of pSS-related ILD, providing the background and rationale for the following original works.
Chapter 3 describes a monocentric retrospective study investigating the phenotypic heterogeneity of pSS-ILD patients in our cohort, as well as baseline risk factors for the development of ILD in pSS patients. This chapter also includes a cross-sectional work focusing on the characterization of glandular involvement of pSS-ILD patients in terms of clinical symptoms, functional tests, ultrasound and histopathological findings.
In Chapter 4 a retrospective cohort study describes the outcome and the rate of clinical, functional and radiologic progression of ILD in pSS patients.
Finally, Chapter 5 describes a new PhD project aimed at the identification of novel biological and imaging biomarkers for the early diagnosis as well as the phenotypic and prognostic stratification of ILD related to autoimmune systemic diseases.

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