Systemic Autoimmune Rheumatic Diseases-associated Interstitial Lung Disease

Systemic autoimmune rheumatic diseases (SARDs), including rheumatoid arthritis (RA), systemic lupus erythematosus, systemic sclerosis (SSc), Sjögren’s syndrome, and mixed connective tissue disease, are driven by immune-mediated inflammation, leading to multiorgan damage. Interstitial lung disease (ILD) is a major complication, particularly in SSc and RA, significantly contributing to morbidity and mortality. The pathogenesis involves genetic predisposition, environmental triggers, and immune dysregulation, resulting in pulmonary fibrosis. Advances in diagnostics, such as serologic markers, high-resolution computed tomography chest, and biomarkers, enable early detection. Therapeutic innovations, including biologics, Janus kinase inhibitors, and antifibrotic agents like nintedanib, have transformed ILD management. This review synthesizes the pathophysiology, clinical features, diagnostic strategies, and practical management of SARD-associated ILD, focusing on immunosuppressive therapies, antifibrotics, and multidisciplinary care.