Thoracic Manifestations Of Rheumatic Disease An Issue Of Clinics In Chest Medicine PDF Download

Perhaps the etymologic background of rheumatology foretells the intimate relationship between diseases of the chest and rheumatologic disorders, a common cause of morbidity and mortality. Close collaboration between experts in both disciplines is essential in the comprehensive assessment and management of these complex patients. It has been nearly 10 years since Clinics in Chest Medicine devoted an issue to the pulmonary complications of the rheumatic disease. New antibodies have been discovered that aid in diagnosis and phenotyping of disease and give further insights into pathobiologic mechanisms. We now have criteria for interstitial pneumonia with autoimmune features, which describe individuals with both interstitial lung disease and combinations of other clinical, serologic, and/or pulmonary morphologic features, which presumably originate from an underlying systemic autoimmune condition, but who do not meet current rheumatologic criteria for a defined connective tissue disease. With translation of fundamental discoveries, we have an even greater treatment arsenal that includes new and re-purposed immunosuppressive and biologic therapies, antifibrotic drugs, and agents that target vascular pathways. Data from rigorous placebo-controlled clinical trials now inform treatment decisions. In addition, a greater number of centers are willing to perform lung transplantation in highly complex patients with outcomes mirroring those without rheumatic disease, and there is an evolving role for autologous stem-cell transplantation.