Connective Tissue Diseases (CTDs) include such diseases as lupus, rheumatoid arthritis, and scleroderma, as well as some so called mixed varieties. These diseases are important from a pulmonary standpoint because they can cause serious and irreversible damage to the lungs.
One of the most common pulmonary complications of CTDs is a scarring process that occurs in the lungs over time. It can be seen in CTDs, but is most common in rheumatoid arthritis and scleroderma. The treatment of this scarring effect is the treatment of the underlying disease, which may or may not be effective in curbing the scarring process. Unfortunately, once the scars have occurred there is no treatment that can reverse this damage. Rheumatoid arthritis can be associated with the development of mass-like structures in the lungs. The masses are called rheumatoid nodules. When they occur, making the proper diagnosis is important so as not to miss a lung cancer.
Once again, treatment of these nodules is the treatment of the underlying disease.
Along with lung problems, we can see on x-rays or CT scans, there are problems that can occur that cannot be seen in this manner. CTDs can be associated with elevated pressures in the blood vessels of the lungs and this is referred to as pulmonary arterial hypertension. The CTD most often associated with this problem is scleroderma and the most common symptom is shortness of breath. Specialized testing that includes right heart catheterization is needed to make this diagnosis. In this case, treatment is available and necessary.
