Rheumatological evaluation of patients with interstitial lung disease.

Area of Science:

• Rheumatology
• Pulmonology
• Immunology

Background:

• Interstitial lung disease (ILD) is a frequent manifestation of connective tissue disease (CTD).
• Diagnosing CTD-ILD presents challenges and is crucial for guiding treatment decisions.
• The role of rheumatological assessment in managing ILD patients requires further investigation.

Purpose of the Study:

• To evaluate the utility of systematic rheumatological assessment in aiding pulmonologists.
• To improve the diagnosis and management of patients with ILD.
• To identify the prevalence of rheumatological manifestations in ILD patients.

Main Methods:

• Observational, single-center study involving 100 ILD patients.
• Standardized pulmonary and rheumatological evaluations, including clinical assessment, immunological screening, HRCT, PFTs, and ultrasonography (US).
• US of joints and major salivary glands were performed.

Main Results:

• Rheumatological evaluation identified CTD-ILD in 39 patients, primarily rheumatoid arthritis, primary Sjögren's syndrome, and inflammatory myopathies.
• Musculoskeletal symptoms (joint pain, swelling) and sicca syndrome were prevalent.
• US revealed synovitis, erosions, tenosynovitis, and features of Sjögren's syndrome in a significant number of patients.

Conclusions:

• Musculoskeletal symptoms are common in ILD patients, underscoring the need for rheumatological input.
• Systematic rheumatological assessment enhances CTD-ILD diagnosis and can lead to therapeutic changes.
• Multidisciplinary management involving rheumatologists is recommended for ILD patients.