Letter to the Editor
Does interstitial lung disease behave in the same way in all rheumatic diseases? A review of the literature
¿Se comporta la enfermedad pulmonar difusa igual en todas las enfermedades reumáticas? Revisión de la literatura
Diego Durán Barata
, Andrea Pérez Figuera, Winnifer Briceño Franquiz, Beatriz Pintado Cort
Corresponding author
Servicio de Neumología, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain
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Compatible with lupus erythematosus.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Patrick Nunes Brito, Danielle Pereira Barros, Brenda Nunes Brito, Rayza Brito Silva, Marcus Emilio Costa Maciel, Monica Camilo Nunes de Sousa" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Patrick" "apellidos" => "Nunes Brito" ] 1 => array:2 [ "nombre" => "Danielle" "apellidos" => "Pereira Barros" ] 2 => array:2 [ "nombre" => "Brenda" "apellidos" => "Nunes Brito" ] 3 => array:2 [ "nombre" => "Rayza" "apellidos" => "Brito Silva" ] 4 => array:2 [ "nombre" => "Marcus Emilio" "apellidos" => "Costa Maciel" ] 5 => array:2 [ "nombre" => "Monica" "apellidos" => "Camilo Nunes de Sousa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1699258X23000980" "doi" => "10.1016/j.reuma.2023.03.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X23000980?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574323001053?idApp=UINPBA00004M" "url" => "/21735743/0000001900000007/v1_202309042019/S2173574323001053/v1_202309042019/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Does interstitial lung disease behave in the same way in all rheumatic diseases? A review of the literature" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "407" "paginaFinal" => "408" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Diego Durán Barata, Andrea Pérez Figuera, Winnifer Briceño Franquiz, Beatriz Pintado Cort" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Diego" "apellidos" => "Durán Barata" "email" => array:1 [ 0 => "iago_794@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Andrea" "apellidos" => "Pérez Figuera" ] 2 => array:2 [ "nombre" => "Winnifer" "apellidos" => "Briceño Franquiz" ] 3 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Pintado Cort" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Se comporta la enfermedad pulmonar difusa igual en todas las enfermedades reumáticas? Revisión de la literatura" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">It is well known that there can be lung involvement in some connective tissue diseases (CTDs), and it may even be their first manifestation. For example, Mathai and Danoff described that the CTDs most frequently associated with interstitial lung disease (ILD) are systemic scleroderma and inflammatory myopathies, followed by rheumatoid arthritis (RA), and less frequently Sjögren’s syndrome, or systemic lupus erythematosus (SLE).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In all of these diseases, the most frequently observed pattern is that of systemic scleroderma or systemic lupus erythematosus. Non-specific interstitial pneumonia (NSIP) is the most frequently observed pattern in all of these diseases, except RA, in which the pattern of usual interstitial pneumonia (UIP) prevails.</p><p id="par0010" class="elsevierStylePara elsevierViewall">ILD is the most common pulmonary manifestation in RA, and its prevalence and incidence are unclear (1%–58%). In fact, the prevalence of subclinical ILD ranges from 19% to 57%, and that of clinically significant ILD is around 10% in men and 7% in women. Thus, the cumulative incidence of RA-ILD with clinical impact at 10 years is 5%, at 15 years 6.3%, and at 30 years 6.8%. UIP is the most frequent radiological pattern, which appears in around 50%–60% of cases, followed by the NSIP pattern, although other patterns such as organised pneumonia or desquamative interstitial pneumonia may also appear. In terms of mortality, ILD is the second leading cause of death in RA patients (after cardiovascular disease) and, in fact, women with RA-ILD are 3 times more likely to die than patients without RA.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In systemic scleroderma, interstitial abnormalities are found on high-resolution computed tomography in up to 80% of cases, which rises to 90% in autopsies of these patients,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> of these, about 40% develop clinical symptoms. Nihtyanova et al. found in an observational study that 47% of patients developed clinically significant ILD, most within 5 years of diagnosis, and none after 15 years. NSIP is the most frequent radiological pattern, which appears in 80%–90% of cases, the fibrotic type being more frequent than the cellular type, followed by the UIP pattern in less than 10% of patients. The course of this disease is highly variable; systemic scleroderma-associated ILD accounted for 35% of deaths in the EUSTAR cohort. Notably, the presence of fibrosis on high-resolution computed tomography and decreased FVC on respiratory function tests are independent predictors of mortality in this type of patient.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The prevalence of ILD in inflammatory myopathies is estimated to be 20%–78%.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> NSIP is the most frequent pattern, although it may exist with diffuse alveolar damage or organised pneumonia.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In Sjögren’s syndrome, ILD is the most frequent and severe pulmonary complication, with a prevalence of 20%, and is the first manifestation in 10% of patients. NSIP was the most frequent radiological pattern, in 45% of patients, however, the lymphocytic interstitial pneumonia pattern is the most characteristic but rare. Data on the prognosis of ILD are limited, but 5-year survival rates of up to 89% have been estimated.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, it can be seen that the behaviour of the PDID associated with rheumatic diseases is very varied. In fact, Park et al. studied the evolution of these diseases. They observed that: a) patients with CTD with NSIP pattern had the same survival as patients with the same pattern but without CTD; b) patients with CTD and UIP pattern (except RA) had the same survival as patients with CTD and NSIP pattern, and c) patients with CTD with UIP pattern had longer survival than patients with idiopathic pulmonary fibrosis (IPF).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarises the characteristics of CTD-associated ILD.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CTD: connective tissue disease; DIP: diffuse interstitial pneumonia; ILD: interstitial lung disease; IM: inflammatory myopathies; LIP: lymphocytic interstitial pneumonia; NSIP: non-specific interstitial pneumonia; OP: organised pneumonia; RA: rheumatoid arthritis; SS: systemic scleroderma; UIP: usual interstitial pneumonia.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ILD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IM \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sjögren’s \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prevalence, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1–58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80–90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20–78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Radiological pattern \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">UIP > NSIP > OP, DIP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NSIP > UIP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NSIP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NSIP \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">*LIP: characteristic \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prognosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Second cause after cardiovascular diseases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35% mortality of SS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Survival at 5 years: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Survival at 5 years of 89% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute form: 52% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chronic form: 87% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3259098.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Characteristics of CTD-associated ILD.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of interstitial lung disease associated with connective tissue disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.C. 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| Year/Month | Html | Total | |
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| 2024 October | 19 | 14 | 33 |
| 2024 September | 48 | 23 | 71 |
| 2024 August | 45 | 39 | 84 |
| 2024 July | 37 | 38 | 75 |
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| 2024 March | 39 | 34 | 73 |
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| 2023 May | 0 | 1 | 1 |
