{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:58:21Z","timestamp":1791460701357,"version":"4.3.4"},"reference-count":25,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Rheumatological diseases (RDs) are characterized by autoimmune-mediated organ damage, with the lungs being an important target organ. Almost all compartments of the pulmonary system may be involved, with considerable heterogeneity in the frequency, severity, and spectrum of pulmonary manifestations. This heterogeneity may result in delayed diagnosis and treatment, leading to adverse outcomes. The objective of this study was to characterize the clinical, demographic, serological, and radiological features of pulmonary manifestations across a spectrum of rheumatic diseases.\nThis cross-sectional study was conducted between 2016 and 2023 at a tertiary care center in New Delhi, India. Patients aged \u226518 years with a diagnosed or suspected RD and pulmonary manifestations were included. Patients who did not fulfill the American College of Rheumatology\/European League against Rheumatism classification criteria for RD or the American Thoracic Society\/European respiratory Society criteria for interstitial pneumonia with autoimmune features (IPAF), as well as those with chronic hypersensitivity pneumonitis or sequelae of previous pulmonary infections, were excluded. Of the 783 patients screened, 170 were diagnosed with rheumatology-associated lung disease (RALD) or IPAF. The mean age was 44.3 years, with a marked female predominance (85%). Rheumatoid arthritis (RA) and systemic sclerosis (SSc) accounted for 70% of cases, followed by IPAF, overlap syndromes, Sj\u00f6gren syndrome (SjS), systemic lupus erythematosus (SLE), and idiopathic inflammatory myositis. Twenty-six patients with idiopathic interstitial pneumonia were reclassified as having IPAF, one of whom subsequently progressed to RA. Pulmonary symptoms preceded the diagnosis of RD in 13.6% of patients, occurred concurrently with the diagnosis in 17%, and developed during the course of RD in 69.4%. Antinuclear antibodies and rheumatoid factor were the most commonly detected autoantibodies, while anti-aminoacyl-tRNA synthetase antibodies were identified in 11 patients.\nRA demonstrated the broadest spectrum of pulmonary manifestations. Interstitial lung disease was the predominant pulmonary manifestation across all RDs except SLE. Non-specific interstitial pneumonia and usual interstitial pneumonia patterns accounted for 87% of cases. Other pulmonary manifestations included infections in RA and SLE; vascular and pleural involvement in RA, SSc, and SLE; and airway involvement in RA and SjS. Pulmonary manifestations may precede, coincide with, or develop after the onset of systemic features in RDs. Comprehensive pulmonary evaluation and collaborative care involving rheumatologists and pulmonologists may facilitate earlier diagnosis and optimize the management of RALDs.<\/jats:p>","DOI":"10.4081\/monaldi.2026.4080","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:32:41Z","timestamp":1791459161000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical profile of pulmonary involvement in rheumatological disorders: a cross-sectional study in a rheumatology-associated lung disease clinic"],"prefix":"10.4081","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4797-3210","authenticated-orcid":false,"given":"Indu","family":"MB","sequence":"first","affiliation":[{"name":"Department of Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8532-9857","authenticated-orcid":true,"given":"Desh","family":"Deepak","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brijesh","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9910-6996","authenticated-orcid":false,"given":"Saloni","family":"Narang","sequence":"additional","affiliation":[{"name":"Department of Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2634-4483","authenticated-orcid":false,"given":"Sumit Kumar","family":"Suman","sequence":"additional","affiliation":[{"name":"Department of Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-8638","authenticated-orcid":false,"given":"Ajay","family":"Bhatta","sequence":"additional","affiliation":[{"name":"Department of Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9201-9197","authenticated-orcid":false,"given":"Gunjan","family":"Lalwani","sequence":"additional","affiliation":[{"name":"Department of Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1486-5564","authenticated-orcid":false,"given":"Vardhini","family":"Somayya","sequence":"additional","affiliation":[{"name":"Department of Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1230-7233","authenticated-orcid":false,"given":"Nitin","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2328-9583","authenticated-orcid":false,"given":"Mala","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Department of Microbiology, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9695-2867","authenticated-orcid":false,"given":"Nandini","family":"Duggal","sequence":"additional","affiliation":[{"name":"Department of Microbiology, ABVIMS and Dr Ram Manohar Lohia Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"88301","doi-asserted-by":"crossref","unstructured":"Palmucci S, Galioto F, Fazio G, et al. Clinical and radiological features of lung disorders related to connective-tissue diseases: a pictorial essay. Insights Imaging 2022;13:108.","DOI":"10.1186\/s13244-022-01243-2"},{"key":"88302","doi-asserted-by":"crossref","unstructured":"Connors GR, Christopher-Stine L, Oddis CV, Danoff SK. Interstitial lung disease associated with the idiopathic inflammatory myopathies: what progress has been made in the past 35 years? Chest 2010;138:1464-74.","DOI":"10.1378\/chest.10-0180"},{"key":"88303","doi-asserted-by":"crossref","unstructured":"Restrepo JF, del Rinc\u00f3n I, Battafarano DF, et al. Clinical and laboratory factors associated with interstitial lung disease in rheumatoid arthritis. Clin Rheumatol 2015;34:1529-36.","DOI":"10.1007\/s10067-015-3025-8"},{"key":"88304","unstructured":"Klippel J H. Systemic lupus erythematosus: demographics, prognosis and outcome. J Rheumatol Suppl 1997;48:67-71."},{"key":"88305","doi-asserted-by":"crossref","unstructured":"Doyle TJ, Hunninghake GM, Rosas IO. Subclinical interstitial lung disease: why you should care. Am J Respir Crit Care Med 2012;185:1147-53.","DOI":"10.1164\/rccm.201108-1420PP"},{"key":"88306","doi-asserted-by":"crossref","unstructured":"Marigliano B, Soriano A, Margiotta D, et al. Lung involvement in connective tissue diseases: a comprehensive review and a focus on rheumatoid arthritis. Autoimmun Rev 2013;12:1076-84.","DOI":"10.1016\/j.autrev.2013.05.001"},{"key":"88307","doi-asserted-by":"crossref","unstructured":"Homma Y, Ohtsuka Y, Tanimura K, et al. Can interstitial pneumonia as the sole presentation of collagen vascular diseases be differentiated from idiopathic interstitial pneumonia? Respiration 1995;62:248-51.","DOI":"10.1159\/000196457"},{"key":"88308","doi-asserted-by":"crossref","unstructured":"Fischer A, Antoniou KM, Brown KK, et al. An Official European Respiratory Society\/American Thoracic Society research statement: interstitial pneumonia with autoimmune features. Eur Respir J 2015;46:976-87.","DOI":"10.1183\/13993003.00150-2015"},{"key":"88309","doi-asserted-by":"crossref","unstructured":"Baqir M, Vasirreddy A, Vu AN, et al. Idiopathic pulmonary fibrosis and gastroesophageal reflux disease: a population-based, case-control study. Respir Med 2021;178:106309.","DOI":"10.1016\/j.rmed.2021.106309"},{"key":"88310","doi-asserted-by":"crossref","unstructured":"Bandeira M, Dourado E, Melo AT, et al. Mechanic\u2019s hands are associated with interstitial lung disease in myositis patients regardless of the presence of antisynthetase antibodies. Rheumatology 2023;62:e332-4.","DOI":"10.1093\/rheumatology\/kead274"},{"key":"88311","doi-asserted-by":"crossref","unstructured":"Mukae H, Ishimoto H, Sakamoto N, et al. Clinical differences between interstitial lung disease associated with clinically amyopathic dermatomyositis and classic dermatomyositis. Chest 2009;136:1341-7.","DOI":"10.1378\/chest.08-2740"},{"key":"88312","doi-asserted-by":"crossref","unstructured":"MB I, Deepak D, Bhatta A, et al N. Prevalence of anti-synthetase syndrome in patients of interstitial lung disease with connective tissue diseases and autoimmune features: a cross-sectional study. Mediterr J Rheumatol 2025;36:107-15.","DOI":"10.31138\/mjr.180324.dtc"},{"key":"88313","doi-asserted-by":"crossref","unstructured":"Doyle TJ, Hunninghake GM, Rosas IO. Subclinical interstitial lung disease: why should one care. Am J RespirCrit Care Med 2012;185:1147-53.","DOI":"10.1164\/rccm.201108-1420PP"},{"key":"88314","doi-asserted-by":"crossref","unstructured":"Kim EA, Lee KS, Johkoh T, et al. Interstitial lung diseases associated with collagen vascular diseases: radiologic and histopathologic findings. Radiographics 2002;22:S151-65.","DOI":"10.1148\/radiographics.22.suppl_1.g02oc04s151"},{"key":"88315","doi-asserted-by":"crossref","unstructured":"Cordier JF. Cryptogenic organizing pneumonia. Eur Respir J 2006;28:422-46.","DOI":"10.1183\/09031936.06.00013505"},{"key":"88316","doi-asserted-by":"crossref","unstructured":"Sara AG, Hamdan AJ, Hanaa B, et al. Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review. Ann Thorac Med 2008;3:67-75.","DOI":"10.4103\/1817-1737.39641"},{"key":"88317","doi-asserted-by":"crossref","unstructured":"Manuel RC, Pilar BZ, Rapha\u00e8le S, et al. Characterization of systemic disease in primary Sj\u00f6gren's syndrome: EULAR-SS Task Force recommendations for articular, cutaneous, pulmonary and renal involvements. Rheumatology 2015;54:2230-8. Erratum in: Rheumatology 2017;56:1245.","DOI":"10.1093\/rheumatology\/kev200"},{"key":"88318","doi-asserted-by":"crossref","unstructured":"Chung JH, Cox CW, Montner SM, et al. CT features of the usual interstitial pneumonia pattern: differentiating connective tissue disease-associated interstitial lung disease from idiopathic pulmonary fibrosis. AJR Am J Roentgenol 2018;210:307-13.","DOI":"10.2214\/AJR.17.18384"},{"key":"88319","doi-asserted-by":"crossref","unstructured":"Walkoff L, White DB, Chung JH, et al. The four-corner sign: a specific imaging feature in differentiating systemic sclerosis-related interstitial lung disease from idiopathic pulmonary fibrosis. J Thorac Imaging 2018;33:197-203.","DOI":"10.1097\/RTI.0000000000000319"},{"key":"88320","doi-asserted-by":"crossref","unstructured":"Chan ED, Wooten WI, Hsieh EW, et al. Diagnostic evaluation of bronchiectasis. 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Semin Arthritis Rheum 2016;46:109-14.","DOI":"10.1016\/j.semarthrit.2016.02.004"},{"key":"88325","doi-asserted-by":"crossref","unstructured":"Singh R, Krishnamurthy P, Deepak D, et al. Small airway disease and its predictors in patients with rheumatoid arthritis. Respir Investig 2022;60:379-84.","DOI":"10.1016\/j.resinv.2021.12.001"}],"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/4080\/2290","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/4080\/2291","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/4080\/2290","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:32:48Z","timestamp":1791459168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/view\/4080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":25,"URL":"https:\/\/doi.org\/10.4081\/monaldi.2026.4080","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"value":"2532-5264","type":"electronic"},{"value":"1122-0643","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,8]]}}}