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- Title
Rheumatological Assessment Is Important for Interstitial Lung Disease Diagnosis.
- Authors
Levi, Yair; Israeli-Shani, Lilach; Kuchuk, Michael; Shochet, Gali Epstein; Koslow, Matthew; Shitrit, David; Epstein Shochet, Gali
- Abstract
<bold>Objective: </bold>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.<bold>Methods: </bold>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).<bold>Results: </bold>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.<bold>Conclusion: </bold>Adding routine rheumatology assessments could significantly increase diagnostic accuracy and reduce invasive procedures.
- Subjects
INTERSTITIAL lung diseases; LONGITUDINAL method; LUNGS; PHYSICAL diagnosis; PULMONARY function tests; RHEUMATISM; RHEUMATOLOGY; DISEASE complications
- Publication
Journal of Rheumatology, 2018, Vol 45, Issue 11, p1509
- ISSN
0315-162X
- Publication type
journal article
- DOI
10.3899/jrheum.171314