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Bronchiolar disorders in systemic autoimmune rheumatic diseases
Yanisa Kluanwan1,2, Nichthida Tangnuntachai3, Jay H Ryu2
1Division of Pulmonary and Critical Care Medicine, Central Chest Institute of Thailand, Nonthaburi, Thailand.
Summary
Small airway diseases (SAD) are frequent in systemic autoimmune rheumatic diseases (SARDs), sometimes presenting as the primary issue. This review details their incidence, symptoms, and treatments across various SARDs.
Area of Science:
- Rheumatology and Pulmonology
- Systemic Autoimmune Rheumatic Diseases (SARDs)
- Bronchiolar Disorders (BDs) / Small Airway Diseases (SAD)
Background:
- Pulmonary involvement is a significant complication of SARDs, affecting airways, lung parenchyma, pleura, and respiratory mechanics.
- Bronchiolar disorders (BDs), also known as small airway diseases (SAD), are common manifestations in SARDs patients and can be the predominant clinical feature.
Purpose of the Study:
- To conduct a comprehensive literature review on bronchiolar disorders (BDs) associated with systemic autoimmune rheumatic diseases (SARDs).
- To summarize the current knowledge regarding the incidence, clinical features, pathogenesis, diagnostic methods, and therapeutic strategies for BDs in SARDs.
Main Methods:
- A systematic literature search was performed using keywords such as "bronchiolitis," "small airway diseases," and specific SARD names.
- Articles published between January 1977 and April 2024 were collated and reviewed.
- The review focused on summarizing data related to incidence, clinical manifestations, pathogenetic mechanisms, pulmonary function tests, imaging, histopathology, and treatment.
Main Results:
- Bronchiolar disorders (BDs) are a common pulmonary complication across a spectrum of SARDs.
- The review highlights BDs in Sjögren syndrome, rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus, idiopathic inflammatory myositis, mixed connective tissue disease, and ankylosing spondylitis.
- Key aspects including prevalence, clinical presentation, underlying mechanisms, diagnostic findings, and treatment outcomes are discussed for each associated SARD.
Conclusions:
- Bronchiolar disorders represent a significant and often under-recognized pulmonary manifestation of systemic autoimmune rheumatic diseases.
- Understanding the specific characteristics of BDs in different SARDs is crucial for accurate diagnosis and effective management.
- Further research is warranted to elucidate pathogenetic mechanisms and optimize treatment strategies for these conditions.
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