Περίληψη:
In patients with interstitial lung disease (ILD), the diagnosis of
idiopathic interstitial pneumonia is usually made after excluding, among
other conditions, connective tissue diseases (CTDs). Although in most
patients with a CTD and respiratory symptoms, the systemic nature of the
disease is obvious, the ILD-related manifestations in CTDs may often
dominate the clinical picture or precede systemic findings and thus
mimic idiopathic interstitial pneumonia. With the exception of systemic
lupus erythematosus, all CTDs may imitate chronic idiopathic
interstitial pneumonias. In this setting, clues to an underlying CTD may
be entirely absent or include subtle findings from various systems,
including skin, vascular and musculoskeletal system or internal organs.
Since nonspecific interstitial pneumonia is a relatively frequent
histological pattern in CTDs, biopsy reports of nonspecific interstitial
pneumonia should also prompt a search for an underlying CTD. Ultimately,
diagnosis of a CTD requires confirmation with immunological testing;
interpretation of the various laboratory tests should always be carried
out in conjunction with clinical findings. The present article reviews
specific clinical aspects of connective tissue disease-related
interstitial lung disease that may help differentiate it from idiopathic
interstitial pneumonia, especially when interstitial lung disease is the
predominant or sole manifestation of an occult connective tissue
disease.
Συγγραφείς:
Tzelepis, G. E.
Toya, S. P.
Moutsopoulos, H. M.
