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

Claudio Tirelli, Valentina Morandi, Adele Valentini, Claudia La Carrubba, Roberto Dore, Giovanni Zanframundo, Patrizia Morbini, Silvia Grignaschi, Andrea Franconeri, Tiberio Oggionni, Emiliano Marasco, Ludovico De Stefano, Zamir Kadija, Francesca Mariani, Veronica Codullo, Claudia Alpini, Carlo Scirè, Carlomaurizio Montecucco, Federica Meloni, Lorenzo Cavagna

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number11
JournalFrontiers in Medicine
Volume7
DOIs
Publication statusPublished - Feb 18 2020

Keywords

  • connective tissue diseases
  • early diagnosis
  • interstitial lung disease
  • multidisciplinary team
  • pulmonology
  • radiology
  • rheumatology

ASJC Scopus subject areas

  • Medicine(all)

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