Characteristics of Connective Tissue Diseases Interstitial Lung Diseases (CTD-ILD) Presenting in a Tertiary Care Hospital
DOI:
https://doi.org/10.51985/JBUMDC2025757Keywords:
Autoimmune Disorders; Connective Tissue Diseases; Interstitial Lung Diseases; Rheumatoid Arthritis; SystemicAbstract
bjective: To determine the characteristics of connective tissue diseases–interstitial lung diseases (CTD-ILD) presenting
in a tertiary care hospital.
Study design and setting: This descriptive cross-sectional study was conducted at the Department of Pulmonology, Ojha
Institute of Chest Disease, Dow University of Health Sciences, Karachi, from 11th February 2025 till 26th July 2025.
Methodology: For 6 months study patients aged 18–80 years diagnosed with ILD on the basis of clinical presentation and
radiological features were included. High-resolution computed tomography (HRCT) was performed to confirm ILD, while
connective tissue disease diagnoses were based on clinical criteria. Demographic data, clinical features, comorbidities, and
HRCT findings were recorded. Data were analyzed using SPSS version 25. Frequencies, percentages, and mean ± SD were
calculated. Chi-square test was applied for categorical variables with p = 0.05 considered significant.
Results: Among 54 CTD-ILD patients (mean age 51.9 ± 12.4 years, 70.4% females), rheumatoid arthritis (53.7%) was
the most common underlying disease. Honeycombing (87.0%) and septal thickening (75.9%) were the predominant HRCT
abnormalities. On stratified analysis, diabetes mellitus (p = 0.026) and smoking (p = 0.021) were more frequent in RAILD. Younger patients (18–40 years) more often had IPAF and SLE compared to older patients (p = 0.002).
Conclusion: RA was the main cause of CTD-ILD, with honeycombing and septal thickening as key HRCT patterns. CTDILD subtypes were significantly linked to diabetes, smoking, septal thickening, and age.
References
1. Mogyoróssy S, Nagy-Vincze M, Griger Z, Dankó K, Szabó
Na, Szekanecz Z, Et Al. Novel Aspects Of Muscle Involvement
In Immune-Mediated Inflammatory Arthropathies And
Connective Tissue Diseases. Autoimmune Rev.
2023;22(5):103311. Doi: Https://Doi.Org/10.1016/ J.Autrev.
2023.103311.
2. Shi Y, Jiang N, Li M, Zeng X, Tian X. Mesenchymal Stem
Cells And Connective Tissue Diseases: From Bench To
Bedside. J Transl Int Med. 2022;11(1):30–45. Doi:
Https://Doi.Org/10.1515/Jtim-2022-0004.
3. Chan C, Ryerson Cj, Dunne Jv, Wilcox Pg. Demographic
And Clinical Predictors Of Progression And Mortality In
Connective Tissue Disease-Associated Interstitial Lung
Disease: A Retrospective Cohort Study. Bmc Pulm Med.
2019;19(1):192. Doi: Https://Doi.Org/10.1186/S12890-019-
0955-Y.
4. Shao T, Shi X, Yang S, Zhang W, Li X, Shu J, Et Al. Interstitial
Lung Disease In Connective Tissue Disease: A Common
Lesion With Heterogeneous Mechanisms And Treatment
Considerations. Front Immunol. 2021;12:684699. Doi:
Https://Doi.Org/10.3389/Fimmu.2021.684699.
5. Matson Sm, Demoruelle Mk. Connective Tissue DiseaseAssociated Interstitial Lung Disease. Immunol Allergy Clin
North Am. 2023;43(2):229–44. Doi: Https://Doi. Org/10.1016/
J.Iac.2023.01.003.
6. Cerro Chiang G, Parimon T. Understanding Interstitial Lung
Diseases Associated With Connective Tissue Disease (CtdIld): Genetics, Cellular Pathophysiology, And Biologic Drivers.
Int J Mol Sci. 2023;24(3):2405. Doi: Https://Doi.Org/
10.3390/Ijms24032405.
7. Yoo H, Hino T, Han J, Franks Tj, Im Y, Hatabu H, Et Al.
Connective Tissue Disease-Related Interstitial Lung Disease
(Ctd-Ild) And Interstitial Lung Abnormality (Ila): Evolving
Concept Of Ct Findings, Pathology And Management. Eur
J Radiol Open. 2020;8:100311. Doi: Https://Doi.Org/ 10.1016/
J.Ejro.2020.100311.
8. Atzeni F, Gerardi Mc, Barilaro G, Masala If, Benucci M,
Sarzi-Puttini P. Interstitial Lung Disease In Systemic
Autoimmune Rheumatic Diseases: A Comprehensive Review.
Expert Rev Clin Immunol. 2018;14(1):69–82. Doi:
Https://Doi.Org/10.1080/1744666x.2018.1411197
9. Mira-Avendaño I, Rivera F, Rojas C, Gómez D, Martínez P.
Interstitial Lung Disease In Systemic Sclerosis, Ra, Iim, Sle
And Mctd: Relative Frequencies Of Ct Imaging Patterns. Rev
Colomb Reumatol. 2024;31(1):45–53. Doi: Https://Doi.Org/
10.1016/J.Rcreu.2023.07.002.
10. Jepsen Y, Alarcon M, Klein U, Thomsen A. Practical Guidance
For Early Recognition And Follow-Up Of Patients With CtdIld. Clin Rheumatol. 2024;43(2):317–25. Doi:
Https://Doi.Org/10.1007/S10067-023-06584-Y.
11. Raghu G, Remy-Jardin M, Myers Jl, Richeldi L, Ryerson Cj,
Lederer Dj, Et Al. Diagnosis Of Idiopathic Pulmonary Fibrosis:
Ats/Ers/Jrs/Alat Guideline. Am J Respir Crit Care Med.
2018;198(5):E44–68. Doi: Https://Doi.Org/ 10.1164/
Rccm.201807-1255st.
12. Jayasinghe P, Wickramasinghe N, Krishnakumar P, Sadikeen
A, Fernando A. Characteristics Of Connective Tissue Diseases
Associated Interstitial Lung Diseases – A Single Centre Study
In Sri Lanka. Ceylon Med J. 2021;66(1):38–43. Doi:
Https://Doi.Org/10.4038/Cmj.V66i1.9405.
13. Antoniou Km, Margaritopoulos Ga, Goh Ns, Hansell Dm,
Nicholson Ag. Honeycombing In Usual Interstitial Pneumonia:
Prognostic Significance. Eur Respir J. 2016;48(5):1518–28.
Doi: Https://Doi.Org/10.1183/13993003.01082-2016.
14. Kim Ej, Elicker Bm, Maldonado F, Webb Wr, Ryu Jh, Van
Uden Jh, Et Al. Usual Interstitial Pneumonia In Rheumatoid
Arthritis-Associated Ild. Arthritis Res Ther. 2010;12(2):R79.
Doi: Https://Doi.Org/10.1186/Ar2987.
15. Yoo H, Hino T, Han J, Franks Tj, Im Y, Hatabu H, Et Al.
Connective Tissue Disease-Related Interstitial Lung Disease
And Interstitial Lung Abnormality: Evolving Concepts Of Ct
Findings, Pathology, And Management. Eur J Radiol Open.
2020;8:100311. Doi: Https://Doi.Org/10.1016/ J.Ejro.2020
.100311.
16. Wells Au, Denton Cp. Interstitial Lung Disease In Systemic
Sclerosis: Nsip Vs Uip. Rheumatology (Oxford). 2014;53(9):
1612–21. Doi: Https://Doi.Org/10.1093/ Rheumatology/
Keu165.
17. Kelly Ca, Saravanan V, Nisar M, Arthanari S, Woodhead Fa,
Price-Forbes An, Et Al. Rheumatoid Arthritis-Related
Interstitial Lung Disease: Associations With Diabetes And
Other Comorbidities. Ann Rheum Dis. 2014;73(8):1511–9.
Doi: Https://Doi.Org/10.1136/Annrheumdis-2012-203160.
18. Sparks Ja, Chang Sc, Liao Kp, Costenbader Kh, Karlson Ew.
Associations Of Smoking And Rheumatoid Arthritis-Related
Interstitial Lung Disease Risk. Arthritis Care Res (Hoboken).
2019;71(2):187–95. Doi: Https://Doi.Org/10.1002/Acr.23782.
19. Iqbal K, Kelly C. Interaction Of Smoking And Anti-Ccp In
Rheumatoid Arthritis-Associated Ild. Rheumatology (Oxford).
2021;60(1):104–12. Doi: Https://Doi.Org/10.1093/
Rheumatology/Keaa223.
20. Singh N, Varghese J, Verma S, Agarwal V, Misra R. Interstitial
Lung Disease In Systemic Lupus Erythematosus: Clinical
Spectrum And Prognosis. Lupus. 2016;25(9):960–8. Doi:
Https://Doi.Org/10.1177/0961203315622824.
21. Assayag D, Kim Ej, Elicker Bm, Collard Hr, King Te Jr.
Survival Trends In Connective Tissue Disease-Related
Interstitial Lung Disease: Influence Of Hrct Pattern. Chest.
2014;146(3):633–40
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