Pulmonary Complications of Connective Tissue Disease

We are honored to have the opportunity to co-guest edit this issue of the Seminars in Respiratory and Critical Care Medicine. In this issue, you will find articles that review the pulmonary complications of connective tissue disease (CTD), with the overwhelming focus on interstitial lung disease (ILD). Where it made sense, we aimed to have two authors—a pulmonologist and a rheumatologist—working together to write each article. We also attempted to capture views from physicians outside the United States by including authors from Canada, Germany, Greece, the UK, and Australia. Our hope was that this approach would encourage the production of articles that merge the knowledge, practice, and experience from around the globe and from the two disciplines with the greatest interest in patients with CTD-related pulmonary complications. We anticipate this volume will serve as a valuable, state-of-the-art reference for physicians in these two specialties; we believe practitioners in disciplines other than pulmonology and rheumatology will also enjoy this volume and find its articles interesting and informative.

Drs. Fischer and Richeldi kick off the volume with an article in which they remind us that CTD-related lung disease can present several challenges to the practitioner. The authors lay out a framework for how pulmonologists and rheumatologists can—and must—collaborate effectively in diagnosing and treating patients with CTD-related lung disease. In the next article, Drs. Jacob, Nair, and Hansell cover chest imaging in the CTDs. They discuss the merits and shortcomings of using various radiologic modalities in patients with CTD-related lung disease, highlight strategies for interpreting pulmonary radiologic studies in these patients, and stress that CTD must always be considered in patients with multicompartment lung disease (when any two or more of the airways, parenchyma, pleura, pulmonary vasculature, or respiratory muscles are involved). In the third article, Drs. Bonella and Costabel take the reader to the cutting edge of knowledge in their comprehensive review of biomarkers in CTD-related lung disease. Drs. Urisman and Jones follow with a compendium on pulmonary pathology in CTD. Their article underscores the heterogeneity in organ injury within and between the CTDs.

In the following five articles, a cadre of expert authors tackles the lung manifestations of particular CTDs: Drs. Wells, Margaritopoulos, Antoniou, and Denton focus their collective effort on bringing the reader fully up to date with an excellent review of ILD in systemic sclerosis. In article 6, Drs. Lake and Proudman present a comprehensive discussion of the pulmonary manifestations of the world's most common CTD, rheumatoid arthritis. Next, Drs. Hallowell, Ascherman, and Danoff share their collaborative knowledge of the pulmonary manifestations of the poly-/dermatomyositis spectrum of disorders. In article 8, Drs. Mittoo and Fell remind the reader of the potentially complex and wide-ranging pulmonary manifestations of systemic lupus erythematosus. In the next article, Drs. Kreider and Highland inform the reader of the various pulmonary complications arising from Sjögren syndrome. We are certain that readers will find the article on immunosuppressive agents by Dr. Maher particularly useful, as they navigate the waters of treating patients with CTD-related pulmonary complications. Drs. Gulati and Antin-Ozerkis close the volume with a comprehensive article on what has come to be known as supportive care—a catch-all phrase that encompasses several non-immunosuppressive interventions used in the care of patients with CTD-related pulmonary pathology.

We appreciate your interest in this volume, and we hope you find its content to be educational and relevant.