Multidisciplinary Approach in the Early Detection of Undiagnosed Connective Tissue Diseases in Patients With Interstitial Lung Disease: A Retrospective Cohort Study

Frontiers in Medicine

article

Claudio Tirelli¹  Tiberio Oggionni¹  Emiliano Marasco²  Ludovico De Stefano²  Zamir Kadija¹  Francesca Mariani¹  Veronica Codullo³  Claudia Alpini⁴  Carlo Scirè²  Carlomaurizio Montecucco²  Federica Meloni¹  Valentina Morandi²  Lorenzo Cavagna²  Adele Valentini⁵  Claudia La Carrubba¹  Roberto Dore⁶  Giovanni Zanframundo²  Patrizia Morbini⁷  Silvia Grignaschi²  Andrea Franconeri⁵ 

[1] Division of Pneumology, University and IRCCS Policlinico S. Matteo Foundation;Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation;Rheumatology Department;Laboratory of Biochemical-Clinical Analyses, IRCCS Policlinico San Matteo Foundation;Institute of Radiology, University and IRCCS Policlinico S. Matteo Foundation;Radiology Unit, Isituti Clinici Città di Pavia;Pathology Unit, University and IRCCS Policlinico S. Matteo Foundation

关键词: interstitial lung disease;    connective tissue diseases;    multidisciplinary team;    early diagnosis;    rheumatology;    pulmonology;    radiology;   

DOI  :  10.3389/fmed.2020.00011

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Interstitial lung disease (ILD) encompasses a wide range of parenchymal lung pathologies with different clinical, histological, radiological, and serological features. Follow-up, treatment, and prognosis are strongly influenced by the underlying pathogenesis. Considering that an ILD may complicate the course of any connective tissue disease (CTD) and that CTD's signs are not always easily identifiable, it could be useful to screen every ILD patient for a possible CTD. The recent definition of interstitial pneumonia with autoimmune features is a further confirmation of the close relationship between CTD and ILD. In this context, the multidisciplinary approach is assuming a growing and accepted role in the correct diagnosis and follow-up, to as early as possible define the best therapeutic strategy. However, despite clinical advantages, until now, the pathways of the multidisciplinary approach in ILD patients are largely heterogeneous across different centers and the best strategy to apply is still to be established and validated. Aims of this article are to describe the organization of our multidisciplinary group for ILD, which is mainly focused on the early identification and management of CTD in patients with ILD and to show our results in a 1 year period of observation. We found that 15% of patients referred for ILD had an underlying CTD, 33% had interstitial pneumonia with autoimmune feature, and 52% had ILD without detectable CTD. Furthermore, we demonstrated that the adoption of a standardized strategy consisting of a screening questionnaire, specific laboratory tests, and nailfold videocapillaroscopy in all incident ILD proved useful in making the right diagnosis.

【 授权许可】

CC BY