Serologic evaluation in idiopathic interstitial pneumonias.
OBJECTIVE
Diagnosis of idiopathic interstitial pneumonias (IIPs) requires the exclusion of, among others, concomitant connective tissue diseases (CTDs), which may present as interstitial lung disease (ILD). This review focuses on the evaluation required to separate these entities through serology, although not exclusively.


RESULTS
Several recent data suggest that patients diagnosed with IIPs can show evidence of CTDs on follow-up. This is especially true for nonspecific interstitial pneumonia but may also be seen with other forms of ILD.


CONCLUSIONS
ILDs may occur alone, IIPs, or in association with, among others, CTDs. In the latter case, they may present before, during or even several months or years after the fulfillment of undisputed criteria for CTDs. If present before, their presentation presupposes their occurrence in early undiagnosed, undefined or undifferentiated CTD, which occasionally indefinitely maintains this status of diagnostic uncertainty, especially if ILD is empirically treated by immunosuppressants. Serologic evaluation for autoantibodies assisted by serum inflammatory biomarkers, detailed search for clinical clues of CTDs and suggestive histopathologic features on lung specimens may provide a framework to build the correct diagnosis. Obtaining a diagnosis of ILD associated with CTD exceeds semantics as this subset of patients may present different natural history, pathobiology, treatment and prognosis.
2nd Department of Pneumonology, Athens Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Haidari, Attika, Greece.
Spyridon A
SA
Papiris
Konstantinos
K
Kagouridis
Demosthenes
D
Bouros
D001323:Autoantibodies / Q000097:blood; D003240:Connective Tissue Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D012698:Serologic Tests
D001323:Autoantibodies