Connective Tissue Disease: Overview

00:01 As you go through this lecture series, you wanna keep in mind that we are causing collateral damage to the lung and when you have such diseases that we'll take a look at in this lecture series including rheumatoid arthritis and scleroderma and company, then what kind of changes are taking place in the lung is what you're asking yourself and here we're still under the category of restrictive lung disease where FEV1 to FEC ratio will never be decreased First, well when you're dealing with restrictive lung disease, the differentiation and the fact that you have so many different conditions that may result in damage to the interstitium is then going to give you various pathologic manifestations but the algorithm that I will show you in a second once again is just to give you an idea as to where on the map of interstitial lung disease you are exactly located.

01:01 Always nice to know where you are in terms of map, isn't it? So many autoimmune diseases have some pulmonary manifestations So what are some of these autoimmune diseases that you are extremely familiar with? SLE, rheumatoid arthritis, scleroderma so those are the ones that we are going to hit usually within the diffused lung disease category, but not always But as far as you're concerned, the type of presentation of your patient when doing a pulmonary function test will be one in which it is suggestive of restrictive lung disease We'll discuss a nonspecific type of interstitial pneumonias what this commonly comes under So many of these autoimmune diseases in which you do have collateral damage to the lung in the form of interstitium then pathologically or histopathologically will then be defined as being nonspecific interstitial pneumonia.

02:01 Once again, just to make sure that you're clear here's that map that I've been referring to with interstitial lung disease and well, you don't have to go through every single box but if you give yourself one big clue or one big differential in this group at least it's giving yourself an idea as to what that group is then referring to thus far, under the category of diffuse parenchymal or interstitial lung disease, there were drugs that we hadn't looked at and with those drugs they include your busulfan, amiodarone and company and we looked at idiopathic interstitial pneumonia and then we walked through nonfamilial and then specifically went into chronic fibrosis with idiopathic pulmonary fibrosis and idiopathic pulmonary fibrosis was the clinical diagnosis Pathologically, you would then find quite a bit of fibrosis you remember the honeycomb type of pattern and then pathologically we then call this "usual interstitial pneumonitis" Current day practice, make sure that you're familiar with the terms and how to interchange them.

03:06 Those are the things that we have discussed already.

03:09 So here, as we go through our diffuse parenchymal lung disease, we'll be focusing upon the nonspecific interstitial pneumonia in which we have autoimmune diseases that is then causing damage to the lung in the area of the interstitium.