Ascertainment of collagen vascular disease in patients presenting with interstitial lung disease

Mittoo, Shikha; Gelber, Allan C.; Christopher‐Stine, Lisa; Horton, Maureen R.; Lechtzin, Noah; Danoff, Sonye K.

doi:10.1016/j.rmed.2009.02.009

Cited by 130 publications

(116 citation statements)

References 24 publications

(10 reference statements)

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“…The prevalence was higher in idiopathic NSIP (24) and similar results were obtained in our present study. ANA is also present in healthy individuals (25-27); 1:40 in 25%-30%, 1:80 in 10%-15%, and 1:160 or greater in 5% (27).…”

Section: Discussionsupporting

confidence: 92%

“…The incidence of CTD in our patients series was found to be low, with only 2.5% in IPF patients (3.8% in IIP), compared with the 19.1% reported by Homma et al (4) and the 17.5% reported by Mittoo et al (24). However, the subject numbers in those two studies were relatively small (n = 13) (4), or (n = 97) (24) and they included other types of interstitial lung disesase with significant referral bias by study design.…”

Section: Discussioncontrasting

confidence: 70%

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Clinical Significance Of Serum Autoantibodies In Idiopathic Interstitial Pneumonia

Kang

Park

Roh

et al. 2012

D104. Connective Tissue Disease Related-Interstitial Lung Disease: Clinical Features and Treatment

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 70%

Clinical Significance Of Serum Autoantibodies In Idiopathic Interstitial Pneumonia

Kang

Park

Roh

et al. 2012

D104. Connective Tissue Disease Related-Interstitial Lung Disease: Clinical Features and Treatment

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“…In a retrospective study at the Johns Hopkins Centre (Baltimore, MA, USA), 114 out of 160 consecutive patients referred for ILD had at least one auto-antibody (and no other identified cause of ILD), of whom 34 satisfied international criteria for a welldefined CTD; although half of those already had an established diagnosis of CTD, another half of these patients had not been previously diagnosed with CTD [28]. Possible reasons as to why the diagnosis of CTD may be missed in the setting of ILD can be summarised as follows [29].…”

Section: Ctd Features May Be Missed In the Diagnostic Approach Of Ildmentioning

confidence: 99%

Significance of connective tissue diseases features in pulmonary fibrosis

Cottin

2013

European Respiratory Review

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Interstitial lung disease (ILD) can occur in any of the connective tissue diseases (CTD) with varying frequency and severity, and an overall long-term prognosis that is less severe than that of idiopathic pulmonary fibrosis (IPF). Because ILD may be the presenting manifestation of CTD and/or the dominant manifestation of CTD, clinical extra-thoracic manifestations should be systematically considered in the diagnostic approach of ILD. When present, autoantibodies strongly contribute to the recognition and classification of the CTD. Patients with clinical extrathoracic manifestations of CTD and/or autoantibodies (especially with a high titer and/or the antibody is considered “highly specific” of an autoimmune condition), but who do not fit with established international CTD criteria may be called undifferentiated CTD or “lung-dominant CTD”. Although it remains to be determined which combination of symptoms and serologic tests best identify the subset of patients with clinically relevant CTD features, available evidence suggests that such patients may have distinct clinical and imaging presentation and may portend a distinct clinical course. However, autoantibodies alone when present in IPF patients do not seem to impact prognosis or management. Referral to a rheumatologist and multidisciplinary discussion may contribute to management of patients with undifferentiated CTD

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“…Most often, interstitial pneumonia arises within the context of an established CTD, but it is not uncommon for the interstitial pneumonia to be the first, and possibly the sole, manifestation of an otherwise occult CTD [7][8][9][10]. Identifying underlying CTD in patients presenting with what is initially considered to be an IIP can be challenging [9,[11][12][13][14][15][16], as boundaries between IIPs and CTD-ILDs are not clearly defined. There is no universally accepted approach to the evaluation of such patients, however, the current international guidelines for the diagnosis of IIP recommend excluding CTD [2,3].…”

Section: Introductionmentioning

confidence: 99%

An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features

et al. 2015

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Many patients with an idiopathic interstitial pneumonia (IIP) have clinical features that suggest an underlying autoimmune process but do not meet established criteria for a connective tissue disease (CTD). Researchers have proposed differing criteria and terms to describe these patients, and lack of consensus over nomenclature and classification limits the ability to conduct prospective studies of a uniform cohort.The "European Respiratory Society/American Thoracic Society Task Force on Undifferentiated Forms of Connective Tissue Disease-associated Interstitial Lung Disease" was formed to create consensus regarding the nomenclature and classification criteria for patients with IIP and features of autoimmunity.The task force proposes the term "interstitial pneumonia with autoimmune features" (IPAF) and offers classification criteria organised around the presence of a combination of features from three domains: a clinical domain consisting of specific extra-thoracic features, a serologic domain consisting of specific autoantibodies, and a morphologic domain consisting of specific chest imaging, histopathologic or pulmonary physiologic features.A designation of IPAF should be used to identify individuals with IIP and features suggestive of, but not definitive for, a CTD. With IPAF, a sound platform has been provided from which to launch the requisite future research investigations of a more uniform cohort. @ERSpublications ERS/ATS task force provides nomenclature and classification criteria for patients with IIP and autoimmune features

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Ascertainment of collagen vascular disease in patients presenting with interstitial lung disease

Abstract: Unrecognized collagen vascular disease may be more common than previously appreciated among patients referred with ILD. High titer ANA and an elevated CPK or aldolase are associated with a CVD diagnosis in this referral population.

Cited by 130 publications

References 24 publications

Clinical Significance Of Serum Autoantibodies In Idiopathic Interstitial Pneumonia

Clinical Significance Of Serum Autoantibodies In Idiopathic Interstitial Pneumonia

Significance of connective tissue diseases features in pulmonary fibrosis

An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features

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