Rheumatological Assessment Is Important for Interstitial Lung Disease Diagnosis
| Autor: | David Shitrit, Gali Epstein Shochet, Michael Kuchuk, Yair Levi, Lilach Israeli-Shani, Matthew Koslow |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Immunology Physical examination Antisynthetase syndrome Bronchoscopies Pulmonary function testing 03 medical and health sciences Idiopathic pulmonary fibrosis 0302 clinical medicine Rheumatology Internal medicine Rheumatic Diseases medicine Immunology and Allergy Humans Prospective Studies Lung Physical Examination Aged 030203 arthritis & rheumatology Aged 80 and over medicine.diagnostic_test business.industry Interstitial lung disease Middle Aged medicine.disease Connective tissue disease Respiratory Function Tests 030228 respiratory system Female business Lung Diseases Interstitial |
| Zdroj: | The Journal of rheumatology. 45(11) |
| ISSN: | 0315-162X |
| Popis: | Objective.Interstitial lung diseases (ILD) form a diverse group of parenchymal lung disorders. Currently, a multidisciplinary team (MDT) including pulmonologists, radiologists, and pathologists is the gold standard for ILD diagnosis. Recently, additional subtypes of connective tissue disease (CTD)-ILD with autoimmune features were defined, making the rheumatological assessment increasingly important. We aimed to assess the effect of adding a rheumatologist to the MDT for routine rheumatology assessment.Methods.A prospective study that assessed newly diagnosed ILD patients by 2 parallel blinded arms; all patients were evaluated by both MDT (e.g., history, physical examination, blood tests, pulmonary function tests, and biopsies, if needed) and a rheumatologist (e.g., history, physical examination, blood and serological tests).Results.Sixty patients were assessed with the mean age of 67.3 ± 12 years, 55% male, and 28% smokers. The rheumatological assessment reclassified 21% of the idiopathic pulmonary fibrosis as CTD. Moreover, the number of CTD-ILD with autoimmune features was increased by 77%. These included antineutrophil cytoplasmic antibody–associated vasculitis, antisynthetase syndrome, and IgG4-related ILD. Retrospectively, rheumatological evaluation could have saved 7 bronchoscopies and 1 surgical biopsy.Conclusion.Adding routine rheumatology assessments could significantly increase diagnostic accuracy and reduce invasive procedures. |
| Databáze: | OpenAIRE |
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