https://doi.org/10.4081/monaldi.2021.1624

Clinico-radiological profile of connective tissue disease related-interstitial lung diseases from a tertiary care centre of India: a cross sectional study

Vol. 91 No. 4 (2021)
Submitted: September 26, 2020
Accepted: March 22, 2021
Published: April 2, 2021
Connective tissue diseases, interstitial lung diseases, spirometry, HRCT thorax, prognosis
Abstract Views: 4026
PDF: 1203
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Mehul Agarwal
Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, India.
Manohar Lal Gupta
Department of Pulmonary Medicine, Santokba Durlabhji Memorial Hospital, Jaipur, India.
Kunal Deokar
Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, India.
Benhur Joel Shadrach
benjoe6326@gmail.com
https://orcid.org/0000-0002-2314-2306
Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, India.
Neha Bharti
Department of Anaesthesia and Critical Care, All India Institute of Medical Sciences, Jodhpur, India.
Maldev Sonigra
Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, India.

Interstitial lung diseases (ILDs) are a frequently occurring pulmonary manifestation in patients of connective tissue diseases (CTD). Detailed understanding of this subset of lung diseases is vital, hence the study was conducted to analyze the clinico-radiological characteristics of CTD-ILD. The present study was conducted between March 2017 to February 2018 at a tertiary care teaching hospital from western India. A total of 100 patients having respiratory symptoms suggestive of ILD, who were either diagnosed cases of CTD or had clinical manifestations of underlying CTD, were included in the study.  27% of patients belonged to age group 41-50 years and 78% were females. Chief respiratory complaints were dyspnea and cough. Clubbing was present in 29% patients. The most common CTDs were rheumatoid arthritis [RA] (26%), systemic sclerosis [SSC] (21%), mixed connective tissue disorder [MCTD] (19%) and Sjogren’s syndrome [SS] (16%). Restrictive defect on spirometry was seen in 58% cases and was most significant among patients with RA (65%) and SS (62%). Pulmonary arterial hypertension was seen in 40% cases and was most evident in MCTD (78%) and SSC patients (58%). Chest radiograph was normal in 47% of subjects. Most common radiological pattern on high resolution computed tomography (HRCT) thorax was non-specific interstitial pneumonia (42%) followed by usual interstitial pneumonia (21%). ILD is a common manifestation of CTD. Work-up for an underlying CTD should be offered to all ILD patients and vice versa.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Antoniou KM, Margaritopoulos G, Economidou F, Siafakas NM. Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement. Eur Respir J 2009;33:882-96. DOI: https://doi.org/10.1183/09031936.00152607
Gutsche M, Rosen GD, Swigris JJ. Connective tissue disease-associated interstitial lung disease: A review. Curr Respir Care Rep 2012;1:224-32. DOI: https://doi.org/10.1007/s13665-012-0028-7
Ysamat Marfá R, Benito Ysamat A, Espejo Pérez S, et al. Lung disease associated with connective tissue disease. Radiologia 2013; 5:107-17. DOI: https://doi.org/10.1016/j.rx.2012.03.004
Quanjer PH, Tammeling GJ, Cotes JE, et al. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 1993;16:5-40. DOI: https://doi.org/10.1183/09041950.005s1693
Raghu G, Remy-Jardin M, Myers JL, et al. Diagnosis of idiopathic pulmonary fibrosis. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med. 2018;198:e44-68.
Navaratnam V, Ali N, Smith CJ, McKeever T, Fogarty A, Hubbard RB. Does the presence of connective tissue disease modify survival in patients with pulmonary fibrosis? Respir Med 2011;105:1925-30. DOI: https://doi.org/10.1016/j.rmed.2011.08.015
Verma SK, Saheer S, Kumar P, et al. Respiratory manifestations among patients with connective tissue disorders. J Indian Acad Clin Med 2013;14:28-32.
de Lauretis A, Veeraraghavan S, Renzoni E. Review series: Aspects of interstitial lung disease: connective tissue disease-associated interstitial lung disease: how does it differ from IPF? How should the clinical approach differ? Chron Respir Dis 2011;8:53-82. DOI: https://doi.org/10.1177/1479972310393758
Gaude GS, Mahishale V, Srivastava A. Pulmonary manifestations in connective tissue disorders: hospital-based study at a tertiary care hospital. Indian J Chest Dis Allied Sci 2009;51:145-51.
Singh S, Collins BF, Sharma BB, et al. Interstitial lung disease in India. Results of a prospective registry. Am J Respir Crit Care Med 2017;195:801-13. DOI: https://doi.org/10.1164/rccm.201607-1484OC
Kumar R, Gupta N, Goel N. Spectrum of interstitial lung disease at a tertiary care centre in India. Pneumonol Alergol Pol 2014;82:218-26. DOI: https://doi.org/10.5603/PiAP.2014.0029
Udayakumar N, Venkatesan S, Rajendiran C. Pulmonary hypertension in rheumatoid arthritis--relation with the duration of the disease. Int J Cardiol 2008;127:410-12. DOI: https://doi.org/10.1016/j.ijcard.2007.04.084
Tanaka N, Kim JS, Newell JD, et al. Rheumatoid arthritis-related lung diseases: CT findings. Radiology 2004;232:81-91. DOI: https://doi.org/10.1148/radiol.2321030174
Lee HK, Kim DS, Yoo B, et al. Histopathologic pattern and clinical features of rheumatoid arthritis-associated interstitial lung disease. Chest 2005;127:2019-27. DOI: https://doi.org/10.1378/chest.127.6.2019
Shannon TM, Gale ME. Noncardiac manifestations of rheumatoid arthritis in the thorax. J Thorac Imaging 1992;7:19-29. DOI: https://doi.org/10.1097/00005382-199203000-00004
Meier FM, Frommer KW, Dinser R, et al. Update on the profile of the EUSTAR cohort: an analysis of the EULAR Scleroderma Trials and Research group database. Ann Rheum Dis 2012;71:1355-60. DOI: https://doi.org/10.1136/annrheumdis-2011-200742
Serra G, Brun AL, Ialongo P, et al. Thoracic involvement in connective tissue diseases: Radiological patterns and follow-up. JBR-BTR 2015;98:3-19.
Misra R, Hissaria P, Tandon V, et al. Primary Sjogren's syndrome: rarity in India. J Assoc Physicians India 2003;51:859-62.
Ito I, Nagai S, Kitaichi M, et al. Pulmonary manifestations of primary Sjogren's syndrome: a clinical, radiologic, and pathologic study. Am J Respir Crit Care Med 2005;171:632-8. DOI: https://doi.org/10.1164/rccm.200403-417OC
Kakati S, Doley B, Pal S, Deka UJ. Pulmonary manifestations in systemic lupus erythematosus (SLE) with special reference to HR CT. J Assoc Physicians India 2007;55:839-41.
Weinrib L, Sharma OP, Quismorio FP Jr. A long-term study of interstitial lung disease in systemic lupus erythematosus. Semin Arthritis Rheum 1990;20:48-56. DOI: https://doi.org/10.1016/0049-0172(90)90094-V
Quadrelli SA, Alvarez C, Arce SC, et al. Pulmonary involvement of systemic lupus erythematosus: analysis of 90 necropsies. Lupus 2009;18:1053-60. DOI: https://doi.org/10.1177/0961203309106601
Douglas WW, Tazelaar HD, Hartman TE, et al. Polymyositis-dermatomyositis-associated interstitial lung disease. Am J Respir Crit Care Med 2001;164:1182-5. DOI: https://doi.org/10.1164/ajrccm.164.7.2103110

How to Cite

Agarwal, Mehul, Manohar Lal Gupta, Kunal Deokar, Benhur Joel Shadrach, Neha Bharti, and Maldev Sonigra. 2021. “Clinico-Radiological Profile of Connective Tissue Disease Related-Interstitial Lung Diseases from a Tertiary Care Centre of India: A Cross Sectional Study”. Monaldi Archives for Chest Disease 91 (4). https://doi.org/10.4081/monaldi.2021.1624.
Copyright (c) 2021 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.