|Year : 2021 | Volume
| Issue : 5 | Page : 1-2
Interstitial lung disease in rheumatic diseases
Sham Santhanam1, Mohit Goyal2
1 Department of Rheumatology, Gleneagles Global Health City, Chennai, Tamil Nadu, India
2 Division of Rheumatology, CARE Pain and Arthritis Centre, Udaipur, Rajasthan, India
|Date of Submission||06-Dec-2021|
|Date of Acceptance||08-Dec-2021|
|Date of Web Publication||21-Dec-2021|
Dr. Sham Santhanam
344/107, Lakshmanaswamy Salai, KK Nagar West, Chennai - 600 078, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Santhanam S, Goyal M. Interstitial lung disease in rheumatic diseases. Indian J Rheumatol 2021;16, Suppl S1:1-2
Interstitial lung disease (ILD) refers to a group of conditions marked by inflammation and scarring of the lung tissue. The diagnosis and management of ILD have always been challenging due to the heterogeneous nature of this condition. ILD is commonly associated with connective tissue diseases (CTD). Timely recognition and optimum treatment are even more relevant to connective tissue disease-associated interstitial lung disease (CTD-ILD), as it generally carries a better prognosis with treatment than idiopathic pulmonary fibrosis. Though ILD is a common extra-articular manifestation of CTDs, there is a lack of consensus and an absence of uniform guidelines for the management of CTD-ILD.
To attract attention to the various issues and challenges related to CTD-ILD, we bring to you this special issue of the Indian Journal of Rheumatology. This supplemental issue with 12 review articles, one original article and one perspective, has a total of 14 articles. It aims to discuss CTD-ILD, the relevant challenges and includes a critical appraisal of the available evidence by concerned experts (rheumatologists, radiologists, pulmonologists and transplant physicians). While the main focus is on ILD associated with connective tissue diseases (rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus, Sjogren's syndrome and overlap syndromes like mixed connective tissue disease), the issue also includes separate reviews on interstitial pneumonia with autoimmune features (IPAF) (which is often considered a continuum of CTD-ILD) and sarcoidosis (which is not uncommon in clinical practice).
The opening article reviews the global and Indian data on the epidemiology and prevalence of CTD-ILD. The next is an original article which sheds light on the real-life data on CTD-ILD in India, something on which not a lot of literature is available from the rheumatology centres. It describes a multicentre observational study that included 620 patients with CTD-ILD at 12 participating rheumatology centres across 10 states of India. Koduri et al. in their write-up on the spectrum of ILD in rheumatic diseases provide a bird's eye view of the heterogeneity within CTD-ILD. This is followed by a detailed insight into the genetics and pathogenesis of CTD-ILD. In the article on IPAF, Karjigi and Dharmanand have provided a detailed review of the entity with a critique on the classification criteria. Talwar et al. have explored the intricacies in the diagnosis and management of pulmonary sarcoidosis. Rao et al. discuss the role of various imaging modalities in CTD-ILD and the review is supplemented with wonderful images and case-based illustrations.
The reviews on the clinical assessment and follow up of ILD by Phanikumar and on the management of CTD-ILD by Talari are likely to be of immense value in clinical practice. Maturu et al., a team of pulmonologists discuss the role of interventions in the diagnosis and management of lung disorders in rheumatic diseases. They have used images from real-life cases to elucidate how interventional modalities can help establish or refute the diagnosis.
Management of rheumatoid arthritis in the background of ILD has always been a subject of debate. Conway et al. present a succinct review of the efficacy and safety of conventional, biologic and targeted synthetic disease-modifying anti-rheumatic drugs in rheumatoid arthritis-associated ILD.
Transplant physicians Rajgopala and Jindal in the next review detail the place of lung transplant in CTD-ILD and the various considerations involved. The next article on updates in the management of CTD-ILD by Kavadichanda et al. summarizes the newer therapies including ongoing trials. In the end, Rowlands, Mehta and Gunawardena present their perspective on the role of a multidisciplinary team approach in the management of CTD-ILD. The authors highlight the need for collaboration between pulmonologists, rheumatologists, radiologists and other concerned specialists in the management of this heterogeneous cohort of patients.
We thank all the authors and the reviewers for their valuable contributions. We sincerely thank the editor-in-chief, Prof. Vikas Aggarwal for his constant encouragement and support. We extend our thanks to the publisher for helping bring out the issue in this shape. We hope this special issue would make for interesting reading and would also provide the readers with a few insights that may be called upon in clinical practice for the management of CTD-ILD.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.