CARACTERÍSTICAS DE PACIENTES CON ENFERMEDAD PULMONAR INTERSTICIAL ASOCIADA A ENFERMEDADES DE TEJIDO CONECTIVO EN LA CAJA DE SEGURO SOCIAL. PANAMÁ.

Lorena Noriega-Aguirre; Ilsa Moreno-Del Cid; Rolando Reyna

Submitted October 30, 2024

Published 2026-02-02

Artículos de Investigación

Vol. 34 No. 2 (2021): Revista Médico Científica

CHARACTERISTICS OF PATIENTS WITH INTERSTICIAL LUNG DISEASE ASSOCIATED WITH CONNECTIVE TISSUE DISEASES IN THE SOCIAL SECURITY. PANAMÁ.

Lorena Noriega-Aguirre⁺⁻
Ilsa Moreno-Del Cid⁺⁻
Rolando Reyna⁺⁻

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Published: 2026-02-02

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Abstract

INTRODUCTION: Diffuse interstitial lung disease associated with connective tissue diseases is the most common cause of interstitial pneumonia. The objective of the study was to describe the characteristics of patients with connective tissue disease who present interstitial lung disease.

MATERIALS AND METHODS: Descriptive and retrospective study in patients with interstitial lung disease associated with connective tissue diseases, with diagnoses established between 2015 and 2019, in the Caja de Seguro Social of Panama.

RESULTS: Thirty-eight cases were analyzed, most of them female (81.58%) with an average age of 57 years. Systemic sclerosis and rheumatoid arthritis were the most frequent collagen diseases, with 21.05% each. Dyspnea in 96.84% and cough in 60.53% were the most frequent respiratory symptoms. The most frequent antibodies were antinuclear antibodies in 34.21%, Anti-Ro, and rheumatoid factor in 18.42% of the cases. The tomographic pattern of nonspecific interstitial pneumonia was found in 34.21% of the cases, and the average value of carbon monoxide diffusion was 56% of the expected value. Steroids (50%) and azathioprine (38.24%) were the most used treatments.

CONCLUSION: The connective tissue diseases most associated with interstitial lung disease were systemic sclerosis and rheumatoid arthritis. Respiratory symptoms are nonspecific; carbon monoxide diffusion and a pattern of nonspecific interstitial pneumonia contribute to the diagnosis.

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BIBLIOGRAFÍA
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Antin-Ozerkis D, Rubinowitz A, Evans J, Homer RJ, Matthay RA. Interstitial lung disease in the connective tissue diseases. Clin Chest Med. 2012;33(1):123-49.
Lega JC, Reynaud Q, Belot A, Fabien N, Durieu I, Cottin V. Idiopathic inflammatory myopathies and the lung. Eur Respir Rev. 2015;24(136):216-38.
Hachulla E, Launay D. Diagnosis and classification of systemic sclerosis. Clin Rev Allergy Immunol. 2011;40(2):78-83.
Nair A, Walsh SL, Desai SR. Imaging of pulmonary involvement in rheumatic disease. Rheum Dis Clin North Am. 2015;41(2):167-96.
Leslie KO, Trahan S, Gruden J. Pulmonary pathology of the rheumatic diseases. Semin Respir Crit Care Med. 2007;28(4):369-78.
Gómez Carrera L, Bonilla Hernan G. Pulmonary manifestations of collagen diseases. Arch Bronconeumol. 2013;49(6):249-60.
Ge Y, Peng Q, Zhang S, Zhou H, Lu X, Wang G. Cyclophosphamide treatment for idiopathic inflammatory myopathies and related interstitial lung disease: a systematic review. Clin Rheumatol. 2015;34(1):99-105.
Miguel-Reyes JL, Gochicoa-Rangel L, Pérez-Padilla R, Torre-Bouscoulet L. Functional respiratory assessment in interstitial lung disease. Rev Invest Clin. 2015;67(1):5-14.
Raghu G, Brown KK. Interstitial lung disease: clinical evaluation and keys to an accurate diagnosis. Clin Chest Med. 2004;25(3):409-19.
Kadoch MA, Cham MD, Beasley MB, Ward TJ, Jacobi AH, Eber CD, et al. Idiopathic interstitial pneumonias: a
radiology-pathology correlation based on the revised 2013 American Thoracic Society-European Respiratory Society
classification system. Curr Probl Diagn Radiol. 2015;44(1):15-25.
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Raghu G, Lynch D, Godwin JD, Webb R, Colby TV, Leslie KO, et al. Diagnosis of idiopathic pulmonary fibrosis with high-resolution CT in patients with little or no radiological evidence of honeycombing: secondary analysis of a
randomised, controlled trial. Lancet Respir Med. 2014;2(4):277-84.
Kalluri M, Claveria F, Ainsley E, Haggag M, Armijo-Olivo S, Richman-Eisenstat J. Beyond Idiopathic Pulmonary Fibrosis Diagnosis: Multidisciplinary Care With an Early Integrated Palliative Approach Is Associated With a Decrease in Acute Care Utilization and Hospital Deaths. J Pain Symptom Manage. 2018;55(2):420-426.
Hoffmann-Vold AM, Allanore Y, Alves M, Brunborg C, Airó P, Ananieva LP, et al. Progressive interstitial lung disease in patients with systemic sclerosis-associated interstitial lung disease in the EUSTAR database. Ann Rheum Dis. 2021;80(2):219-227.
Fernandes L, Nasser M, Ahmad K, Cottin V. Interstitial Pneumonia With Autoimmune Features (IPAF). Front Med.
;6:209.
Sambataro G, Sambataro D, Torrisi SE, Vancheri A, Colaci M, Pavone M, et al. Clinical, serological and radiological
features of a prospective cohort of Interstitial Pneumonia with Autoimmune Features (IPAF) patients. Respir Med.
;150:154-160.
Sebastiani M, Faverio P, Manfredi A, Cassone G, Vacchi C, Stainer A, et al. Interstitial Pneumonia with Autoimmune Features: Why Rheumatologist-Pulmonologist Collaboration Is Essential. Biomedicines. 2020;9(1):17.
Capobianco J, Grimberg A, Thompson BM, Antunes VB, Jasinowodolinski D, Meirelles GS. Thoracic manifestations
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sclerosis interstitial lung disease. Eur Respir Rev. 2018.15;27(148):170102.
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Are Predictive of Mortality in Interstitial Lung Disease Associated With Systemic Sclerosis. Arthritis Rheumatol.
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Fagundes MN, Caleiro MT, Navarro-Rodriguez T, Baldi BG, Kavakama J, Salge JM, et al. Esophageal involvement and interstitial lung disease in mixed connective tissue disease. Respir Med. 2009;103(6):854-60.
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interstitial lung diseases and gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2011;34(11-12):1295-305.

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[1] BIBLIOGRAFÍA

[2] Antoniou KM, Margaritopoulos GA, Tomassetti S, Bonella F, Costabel U, Poletti V. Intertitial Lung disease. Eur Respir Rev. 2014;23(131):40-54.

[3] Antin-Ozerkis D, Rubinowitz A, Evans J, Homer RJ, Matthay RA. Interstitial lung disease in the connective tissue diseases. Clin Chest Med. 2012;33(1):123-49.

[4] Lega JC, Reynaud Q, Belot A, Fabien N, Durieu I, Cottin V. Idiopathic inflammatory myopathies and the lung. Eur Respir Rev. 2015;24(136):216-38.

[5] Hachulla E, Launay D. Diagnosis and classification of systemic sclerosis. Clin Rev Allergy Immunol. 2011;40(2):78-83.

[6] Nair A, Walsh SL, Desai SR. Imaging of pulmonary involvement in rheumatic disease. Rheum Dis Clin North Am. 2015;41(2):167-96.

[7] Leslie KO, Trahan S, Gruden J. Pulmonary pathology of the rheumatic diseases. Semin Respir Crit Care Med. 2007;28(4):369-78.

[8] Gómez Carrera L, Bonilla Hernan G. Pulmonary manifestations of collagen diseases. Arch Bronconeumol. 2013;49(6):249-60.

[9] Ge Y, Peng Q, Zhang S, Zhou H, Lu X, Wang G. Cyclophosphamide treatment for idiopathic inflammatory myopathies and related interstitial lung disease: a systematic review. Clin Rheumatol. 2015;34(1):99-105.

[10] Miguel-Reyes JL, Gochicoa-Rangel L, Pérez-Padilla R, Torre-Bouscoulet L. Functional respiratory assessment in interstitial lung disease. Rev Invest Clin. 2015;67(1):5-14.

[11] Raghu G, Brown KK. Interstitial lung disease: clinical evaluation and keys to an accurate diagnosis. Clin Chest Med. 2004;25(3):409-19.

[12] Kadoch MA, Cham MD, Beasley MB, Ward TJ, Jacobi AH, Eber CD, et al. Idiopathic interstitial pneumonias: a

[13] radiology-pathology correlation based on the revised 2013 American Thoracic Society-European Respiratory Society

[14] classification system. Curr Probl Diagn Radiol. 2015;44(1):15-25.

[15] Koelsch TL, Chung JH, Lynch DA. Radiologic evaluation of idiopathic interstitial pneumonias. Clin Chest Med. 2015;36(2):269-82.

[16] Raghu G, Lynch D, Godwin JD, Webb R, Colby TV, Leslie KO, et al. Diagnosis of idiopathic pulmonary fibrosis with high-resolution CT in patients with little or no radiological evidence of honeycombing: secondary analysis of a

[17] randomised, controlled trial. Lancet Respir Med. 2014;2(4):277-84.

[18] Kalluri M, Claveria F, Ainsley E, Haggag M, Armijo-Olivo S, Richman-Eisenstat J. Beyond Idiopathic Pulmonary Fibrosis Diagnosis: Multidisciplinary Care With an Early Integrated Palliative Approach Is Associated With a Decrease in Acute Care Utilization and Hospital Deaths. J Pain Symptom Manage. 2018;55(2):420-426.

[19] Hoffmann-Vold AM, Allanore Y, Alves M, Brunborg C, Airó P, Ananieva LP, et al. Progressive interstitial lung disease in patients with systemic sclerosis-associated interstitial lung disease in the EUSTAR database. Ann Rheum Dis. 2021;80(2):219-227.

[20] Fernandes L, Nasser M, Ahmad K, Cottin V. Interstitial Pneumonia With Autoimmune Features (IPAF). Front Med.

[21] ;6:209.

[22] Sambataro G, Sambataro D, Torrisi SE, Vancheri A, Colaci M, Pavone M, et al. Clinical, serological and radiological

[23] features of a prospective cohort of Interstitial Pneumonia with Autoimmune Features (IPAF) patients. Respir Med.

[24] ;150:154-160.

[25] Sebastiani M, Faverio P, Manfredi A, Cassone G, Vacchi C, Stainer A, et al. Interstitial Pneumonia with Autoimmune Features: Why Rheumatologist-Pulmonologist Collaboration Is Essential. Biomedicines. 2020;9(1):17.

[26] Capobianco J, Grimberg A, Thompson BM, Antunes VB, Jasinowodolinski D, Meirelles GS. Thoracic manifestations

[27] of collagen vascular diseases. Radiographics. 2012;32(1):33-50.

[28] Koelsch TL, Chung JH, Lynch DA. Radiologic evaluation of idiopathic interstitial pneumonias. Clin Chest Med. 2015;36(2):269-82.

[29] Caron M, Hoa S, Hudson M, Schwartzman K, Steele R. Pulmonary function tests as outcomes for systemic

[30] sclerosis interstitial lung disease. Eur Respir Rev. 2018.15;27(148):170102.

[31] Zamora-Legoff JA, Krause ML, Crowson CS, Ryu JH, Matteson EL. Progressive Decline of Lung Function in

[32] Rheumatoid Arthritis-Associated Interstitial Lung Disease. Arthritis Rheumatol. 2017;69(3):542-549.

[33] Goh NS, Hoyles RK, Denton CP, Hansell DM, Renzoni EA, Maher TM, et al. Short-Term Pulmonary Function Trends

[34] Are Predictive of Mortality in Interstitial Lung Disease Associated With Systemic Sclerosis. Arthritis Rheumatol.

[35] ;69(8):1670-1678.

[36] Cottin V, Valenzuela C. Diagnostic approach of fibrosing interstitial lung diseases of unknown origin. Presse Med. 2020;49(2):104021.

[37] Perelas A, Silver RM, Arrossi AV, Highland KB. Systemic sclerosis-associated interstitial lung disease. Lancet Respir Med. 2020;8(3):304-320.

[38] Fischer A, du Bois R. Interstitial lung disease in connective tissue disorders. Lancet. 2012;380(9842):689-98.

[39] Mathai SC, Danoff SK. Management of interstitial lung disease associated with connective tissue disease. BMJ.

[40] ; 352: h6819.

[41] Fagundes MN, Caleiro MT, Navarro-Rodriguez T, Baldi BG, Kavakama J, Salge JM, et al. Esophageal involvement and interstitial lung disease in mixed connective tissue disease. Respir Med. 2009;103(6):854-60.

[42] Hershcovici T, Jha LK, Johnson T, Gerson L, Stave C, Malo J, et al. Systematic review: the relationship between

[43] interstitial lung diseases and gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2011;34(11-12):1295-305.

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