Rheumathism and pneumology

Abstract

Background: Due to the broad range of diagnostic and therapeutic aspects with an increased risk of mortality, lung manifestations of rheumatic diseases are an exciting and important field in the clinical routine of pulmonologists and rheumatologists. Objective: Discussion of different presentations in the lung, diagnostics and management of lung manifestation associated with rheumatic diseases. Material and methods: Analysis and presentation of current literature on the subject. Results: The manuscript presents forms of lung involvement associated with rheumatic diseases, in particular the connective tissue disease-associated interstitial lung disease. Considering the negative impact on survival, rapid and adequate diagnosis is of great importance. In the case of a known underlying rheumatic disease, histological confirmation of interstitial changes is not always necessary. In addition to the patient’s history, pulmonary function testing and diagnostic imaging with high-resolution CT-scan (HR-CT) are cornerstones of the diagnostic process. The final diagnosis and therapeutic approach should be determined by a multidisciplinary discussion process. The basis of the treatment is immunosuppressants, however the use antifibrotic drugs is currently under investigation in clinical trials. In the case of advanced lung disease, lung transplantation should be evaluated promptly. Conclusion: In the case of pulmonary involvement with rheumatic disease, the teamwork of pulmonologists, rheumatologists and radiologists is of particular importance.