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Lung involvement in connective tissue diseases: A comprehensive review and a focus on rheumatoid arthritis
Authors:Benedetta Marigliano  Alessandra SorianoDomenico Margiotta  Marta VadaccaAntonella Afeltra
Affiliation:Department of Clinical Medicine and Rheumatology, University Campus Bio-Medico of Rome, Italy
Abstract:
The lungs are frequently involved in Connective Tissue Diseases (CTDs). Interstitial lung disease (ILD) is one of the most common pleuropulmonary manifestations that affects prognosis significantly. In practice, rheumatologists and other physicians tend to underestimate the impact of CTD-ILDs and diagnose respiratory impairment when it has reached an irreversible fibrotic stage. Early investigation, through clinical evidence, imaging and – in certain cases – lung biopsy, is therefore warranted in order to detect a possible ILD at a reversible initial inflammatory stage. In this review, we focus on lung injury during CTDs, with particular attention to ILDs, and examine their prevalence, clinical manifestations and histological patterns, as well as therapeutic approaches and known complications till date. Although several therapeutic agents have been approved, the best treatment is still not certain and additional trials are required, which demand more knowledge of pulmonary involvement in CTDs.
Keywords:Interstitial lung disease (ILD)   Rheumatoid arthritis (RA)   Connective tissue diseases (CTDs)   Idiopathic pulmonary fibrosis (IPF)   Treatment
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