General Internal Medicine

Interstitial lung disease

Questions discussed in this category

How do you approach PJP prophylaxis in patients with rheumatic disease on corticosteroids?

Does the presence of ILD change your approach?

Do you seek pathologic confirmation before proceeding with empiric immunosuppressive therapy in symptomatic patients with radiographic NSIP?

1 Answer available

How would you approach management of a patient with seropositive RA and UIP-ILD, with concern for active lung disease?

Joint symptoms are stable on Hydroxychloroquine. Is there benefit of adding methotrexate or Rituximab for lung disease? CT of chest with predominately...

1 Answer available

How do you screen rheumatoid arthritis patients for lung disease (modality, frequency, patient selection)?

This question is part of our collaboration with ACR Convergence 2024 to Continue the Conversation from the meeeting. This question was inspired by the...

5 Answers available

What is your approach to differentiating RA-ILD from medication toxicity (I.e. from methotrexate)?

1 Answer available

How do you approach management of ILD in the presence of weakly positive RF and ANA but no other objective systemic findings of connective tissue disease?

Is this managed as CTD-ILD with immunosuppressive +/- anti-fibrotic agents?

1 Answer available

In a patient with low titer +anti-SAE antibody and known ILD, but no other clinical features of dermatomyositis, how would you approach further testing or would you treat the patient as dermatomyositis associated ILD?

1 Answer available

How do you approach management of new onset ILD in a patient with RA who is otherwise well controlled on methotrexate or leflunomide?

1 Answer available

How do you approach the treatment of indeterminate UIP on HRCT with grossly positive MPO antibody and no other features consistent with AAV?

1 Answer available

What is your approach to management of pulmonary fibrosis in patients with a history of microscopic polyangiitis who do not have other active organ involvement?

Patient is with past history of glomerulonephritis in remission after rituximab for the past 2 years. +MPO/P-ANCA

1 Answer available

How do you manage diarrhea in a patient with CTD-ILD on MMF who was recently started on full dose nintedanib?

5 Answers available

Do you consider immunosuppressive agents in progressive interstitial pneumonias or pneumonitis without a clear driving etiology?

1 Answer available

How would you approach medication de-escalation in a patient with a history of rapidly progressive CTD-ILD who responded to and is currently on mycophenolate 3 grams daily and IVIG 2mg/kg monthly infusions and has been stable for two years?

2 Answers available

What is your approach in differentiating IPAF (interstitial pneumonia with autoimmune features) versus "CTD ILD" in patients with serologic abnormalities but do not fulfill criteria for autoimmune disease?

1 Answer available

What is your initial treatment of choice in patients with RA and associated interstitial lung disease?

1 Answer available

What is your approach to using nintedanib in patients on baseline immunosuppression?

Patients on baseline mycophenolate and azathioprine were excluded from the INBUILD trial however many patients with CTD-ILD will be on some form of im...

5 Answers available

When do you begin antifibrotic therapy for a patient with newly diagnosed ILD that is not IPF?

Do you base the decision on FEV1, 6MWD or symptoms at initial evaluation, or progression over time?

6 Answers available

What dose and duration of steroid therapy do you use in steroid responsive ILD?

1 Answer available

How do you clinically distinguish between group I and group III PH in patients with CTD-ILD?

1 Answer available

Do you consider the use of antifibrotics at presentation in patients with a radiographic UIP pattern of pulmonary fibrosis in the presence of positive serologies without any symptoms of CTD who have not yet demonstrated evidence of a progressive phenotype?

1 Answer available

What is your approach to treatment for a patient with progressive ILD (UIP pattern) with high titer RF but no articular symptoms?

1 Answer available