Interstitial lung diseases (ILD) represent a frequent complication of connective tissue diseases (CTDs), especially systemic sclerosis, idiopathic inflammatory myopathies and rheumatoid arthritis. ILD can either occur during CTD course or be the first manifestation of CTDs. Therefore screening patients with ILD for CTD is crucial. In some cases, ILD are associated with clinical and/or serological autoimmune features but not classifiable for CTDs. Evolution of these forms to defined CTDs has never been study. Recently, the European Respiratory Society/American Thoracic Society experts proposed a new term, "interstitial pneumonia with autoimmune features" or IPAF, to describe these patients according to updated classification criteria. Aims of this study were to compare CTD occurence during follow-up between IPAF and non-IPAF patients in a idiopathic interstitial pneumonia cohort and to identify risk factors of CTD progression in IPAF patients at diagnosis.
Study Type
OBSERVATIONAL
Enrollment
300
Clinical data, radiological data and laboratory tests follow-up
Central Hospital
Lille, France
Central Hospital
Nancy, France
CTD incidence
CTD incidence according to classification criteria: rheumatoid arthritis (2010 ACR/EULAR criteria), systemic erythematosus lupus (2019 ACR/EULAR criteria), Sjögren syndrome (2016 ACR/EULAR criteria), systemic sclerosis (2013 ACR/EULAR criteria), idiopathic inflammatory myopathies (2017 ACR/EULAR criteria) and mixed connective tissue disease (modified Sharp criteria or Alarcon-Segovia criteria or Kasukawa criteria)
Time frame: After 3 years of follow-up
IPAF clinical domain criteria
"mechanic hands", Gottron's sign, distal digital tip ulceration, inflammatory arthritis or polyarticular joint stiffness \> 60mn, telangiectasia, Raynaud's phenomenon, unexplained digital oedema
Time frame: Baseline
IPAF serological domain criteria
ANA titre and pattern, RF, anti-CCP, anti-dsDNA, anti-Ro, anti-La, anti-ribonucleoprotein, anti-Smith, anti-Scl70, anti-tRNA synthetase, anti-PM-Scl, anti-MDA5
Time frame: Baseline
IPAF morphological domain criteria
NSIP, and/or OP, or LIP radiology pattern by HRCT
Time frame: Baseline
ILD severity
PFT (pulmonary function test): FVC, FEV1, DLCO (percentages of predicted values)
Time frame: Baseline, 6 months of follow-up and at the last visit
Survival rate
Time frame: After 3 years and 5 years of follow-up
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