Semin Respir Crit Care Med 2014; 35(02): 159-165
DOI: 10.1055/s-0034-1371530
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cross-Disciplinary Collaboration in Connective Tissue Disease-Related Lung Disease

Aryeh Fischer
1   Division of Rheumatology, National Jewish Health, Denver, Colorado
,
Luca Richeldi
2   Department of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
25 March 2014 (online)

Abstract

Lung disease is a common manifestation of connective tissue disease (CTD) and is associated with significant morbidity and mortality. The evaluation of lung disease, and interstitial lung disease (ILD) in particular, in patients with CTD is complex because of the heterogeneity of the CTDs, the varied types and degrees of severity of ILD encountered, and because ILD can be identified at any point in time in these patients. Cross-disciplinary, thorough evaluations are needed when CTD patients develop ILD or when evaluating ILD patients for the presence of occult CTD. Determining that ILD is associated with an established CTD requires the exclusion of alternative etiologies, and thorough assessments of the clinical features of both the CTD and ILD. The detection of occult CTD in patients with “idiopathic” ILD requires careful attention to the demographic profile, historical clues, subtle physical examination findings, specific autoantibody positivity, radiological and histopathological features, and can be optimized by a multidisciplinary approach that includes rheumatological collaboration. Not all patients with CTD-associated ILD require pharmacological therapy, and management decisions should consider pace and severity of the disease, intra- and extrathoracic features of activity and can be optimized by cross-disciplinary collaboration.

 
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