Clinical and Serological Evaluation and Management of Rheumatic Disease-Associated Interstitial Lung Disease
Abstract
In 2011, the American Thoracic Society (ATS) recommended that antibody testing be included in the evaluation of patients with interstitial lung disease (ILD) to assess for an underlying connective tissue disease, particularly in cases of lingering diagnostic uncertainty, such as differentiating ILD from idiopathic pulmonary fibrosis.¹ Specifically, the ATS endorsed routine testing for antinuclear antibodies (ANA), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti CCP) antibodies.
However, autoantibody testing in isolation is rarely diagnostic and results must be interpreted within a clinical context. Accordingly, the interpretation of autoantibody testing and its implications for the diagnosis and management of rheumatic disease-associated ILD remain central to optimizing care in this patient population.
Serology testing is best utilized as an adjunct rather than a standalone diagnostic tool. Over reliance on antibody results without clinical correlation can result in misdiagnosis and inappropriate treatment. It is therefore important to integrate serologic data into the broader diagnostic workup of systemic autoimmune rheumatic disease-associated ILD.
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