differentail dx adult acute onsetasthma vs connective tissue related lung disease

[laura1964]

I am 43 years old and have undifferentiated connective tissue disease with features of SLE and scleroderma. I had my pfts done which showed early small airway obstruction. My chest xray showed hyperinflated lungs bilaterially. My dr is treating this as asthma, even though I have no asthma hx. He started me on pulmicort inhaler and Proventil. He also wrote a r/o dx of connective tissue related lung disease. Can you please shed some light on these findings for me. The report also said mid expiratory flow reduced to 69% of predicted.
Thanks, Laura

[National Jewish]

Various connective tissue diseases are associated with pulmonary disease such as interstitial lung disease or bronchiolitis obliterans or bronchiolitis obliterans with organizing pneumonia (BOOP).  This type of disease does occur in the small airways.  It results in obstruction of these small airways and is associated with hyperinflation of the lungs.  This is a specialized area called autoimmune lung disease.  You should consult with physicians who have extensive experience with it at National Jewish Medical and Research Center in Denver, Colorado, Mayo Clinic or Johns Hopkins Medical Center in Baltimore, Maryland.