Integrating Multidisciplinary Expertise in the Management of Connective Tissue Disease-Associated Interstitial Lung Disease: Experience from a Quaternary Care Hospital

Le résumé fourni par la source

The diagnosis of interstitial lung disease (ILD) has made significant advances since 2018, 20% of ILD cases are related to connective tissue disease (CTD-ILD) leading to the formation of multidisciplinary teams (MDT). Here we describe the characteristics of patients with CTD-ILD who attended our ILD reference center consisting of 4 pulmonologists, 2 radiologists, 3 pathologists, 1 thoracic surgeon, and 4 rheumatologists in a quaternary care hospital in Bogotá, Colombia from 2018 - 2024. It's a retrospective, observational cohort study on the clinical cases reviewed by our MDT for ILD. Continuous variables were described as mean and standard deviation, while nominal variables were evaluated based on frequencies and percentages Among 155 patients, 59 (38.05%) had confirmed CTD-ILD. Extrapulmonary symptoms were present in 41%, predominantly dry symptoms and arthralgia. Positive antinuclear antibodies (18%), most with an AC-3 and AC-4 pattern, rheumatoid factor (15%), anti-SSA and anti-SSB (8.3%), anti-cyclic citrullinated peptide (7.7%), anti-SCL-70 (5.8%) and antisynthetase antibodies (2.5%). Radiologic patterns were primarily usual interstitial pneumonia (45.4%), nonspecific interstitial pneumonia (23.6%), organizing pneumonia (3.6%. Rheumatoid arthritis was the most common autoimmune disease (20%). Antifibrotic treatment was initiated in 13,5% of our patients. ILD has a significant autoimmune component that requires rheumatologist assessment, with a multidisciplinary management, to improve patients outcomes and quality of life. In our 7-year cohort, we found that rheumatoid arthritis was the most prevalent CTD-ILD.

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