Introduction
There are more than 100 dissimilar autoimmune and inflammatory circumstances in children distressing the muscles, cartilage, joints, bones, and skin 1,2. 294,000 children in the US have been diagnosed with a rheumatologic condition as assessed by Centers for Disease Control (CDC) which regularly first appears between the ages of 5 and 10 years, and girls are affected twofold as often as boys 3, yet prevalence in developing country not correctly estimated. Any organ system can be ed by CTD with a broad variety of disease features and severity, such as rash, arthritis, and more advanced presentation as renal or respiratory failure. The identification of CTD is frequently delayed and identifying the exact nature of CTD can be challenging4 . In SLE, about half of patients have some form of pulmonary immersion throughout the progression of the disease 5-8.
Interstitial lung diseases (ILD) are a cluster of disorders characterized by interstitial inflammation and fibrosis, The prevelance of chILD was approximated annually; 1.3 to 3.6 per 1,000,000 in children under 17 years, 108–162 per 1,000,000 in children under 15 years9-11. The large disparity noted can be clarified by the difference in the population involved in each study and a difference in the criteria of ILD diagnosis. CTD related ILD (CTD-ILD) occurs with development of original disease with difference prevelance12. ILD is the typical presentation of respiratory system involvement in autoimmune connective tissue disease, it’s not limited to the interstitium but also alveoli, pleura, vascular, lymphatic structures, and airways of all diameters may all be included in the disease. ILD when present, is frequently accompanying by significant morbidity and mortality 6.Similarly, 8,13 mentioned that Interstitial lung disease (ILD) is one of the crucial issues that impact the prognosis of connective tissue diseased patients, and can cause uninhibited systemic disease activity in CTD, it can be fatal, and early detecting of the disease is, subsequently, important. Pulmonary function tests are key in assessing CTD patients, PFT inform disease severity at first diagnosis and response to therapy over follow up14 . High-resolution computed tomography (HRCT) is gold corner to diagnose ILD12,15. The pathogenesis of ILD in rheumatic disease is complicated, multifactorial, and incompletely known16-18. The clinical manifestation and progression of ILD involves both inflammatory/immune and fibrotic/tissue components, which often represent a progressive uncontrolled tissue repair reaction in response to injury, finally leading to irreversible remodelling of the lung and diminished lung function