Clinical Profile of Patients with Interstitial Lung Disease with Underlying Autoimmune Rheumatic Disease Presenting to a Tertiary Care Setting: A Descriptive Cross-sectional Study

TL;DR

This study describes the clinical features of patients with interstitial lung disease linked to autoimmune rheumatic diseases in a hospital in Nepal.

Contribution

The study provides a detailed clinical profile of autoimmune rheumatic disease-related interstitial lung disease in a specific geographic and healthcare setting.

Findings

Rheumatoid arthritis was the most common autoimmune rheumatic disease associated with interstitial lung disease.

Usual interstitial pneumonia was the most frequently observed radiographic pattern.

Corticosteroids were the most commonly used treatment among the patients.

Abstract

Interstitial lung diseases are a diverse group of disorders that display considerable overlap clinically, physiologically, and radiologically. A significant subset of these patients has autoimmune rheumatic diseases. This study aimed to characterize the clinical profile of patients with autoimmune rheumatic disease-related interstitial lung disease, focusing on demographic features, radiographic patterns, and treatment practices.

A descriptive cross-sectional study was conducted at the Hospital for Advanced Medicine and Surgery in Kathmandu, Nepal, from May 2022 to May 2023. Patients with interstitial lung disease confirmed by high-resolution computed tomography and a rheumatologist-verified diagnosis of autoimmune rheumatic disease were included. Demographic, clinical, laboratory, imaging, and pulmonary function data were collected and analysed.

A total of 36 patients were included, comprising 28 (77.80%) females and 8 (22.20%) males, with a mean age of 58.92 ± 15.89 years. Rheumatoid arthritis was present in 18 (50%) cases, while undifferentiated systemic rheumatic disease was seen in 7 (19.44 %). Extrapulmonary manifestations were the initial presentation in 24 (66.7%) of cases. Usual interstitial pneumonia was identified in 22 (61.1%) patients. The mean forced vital capacity was 65.90 ± 25.38%, and the mean diffusion capacity of the lungs for carbon monoxide was 47.22 ± 23.21%. Methotrexate and hydroxychloroquine were each used by 6 (16.70%) patients, while corticosteroids were used by 11 (30.60%) patients.

Interstitial lung disease is a significant complication of autoimmune rheumatic diseases. Early identification through regular clinical assessment and imaging is essential to prevent disease progression and improve outcomes.