CLINICO-RADIOLOGICAL AND SEROLOGICAL PROFILE OF INTERSTITIAL LUNG DISEASE INCLUDING CONNECTIVE TISSUE DISEASE-ASSOCIATED ILD: A CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL
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Keywords
Interstitial lung disease; CTD-ILD; IPF; hypersensitivity pneumonitis; HRCT; UIP; GAP score; DLCO; multi-disciplinary discussion
Abstract
Background: Interstitial lung disease (ILD) encompasses a heterogeneous group of diffuse parenchymal lung disorders with distinct aetiologies, radiological patterns, and prognoses. Connective tissue disease-associated ILD (CTD-ILD) constitutes a significant proportion of ILD cases and warrants systematic serological evaluation. Multi-disciplinary discussion (MDD) is the diagnostic gold standard. Methods: A cross-sectional study enrolled 120 adults diagnosed with ILD through multidisciplinary discussion (MDD) at a tertiary care hospital over 24 months. Comprehensive serological, spirometric, HRCT (ATS-2018 UIP classification), 6MWT, and GAP score assessments were performed. Results: CTD-ILD was the most common diagnostic category (32.5%), followed by hypersensitivity pneumonitis (HP, 21.7%), IPF (18.3%), sarcoidosis (12.5%), NSIP (8.3%), and others (6.7%). UIP/probable-UIP pattern on HRCT was present in 62.5% of IPF cases. Mean FVC% predicted was 63.8%; DLCO% 48.2%; mean 6MWD 348 m (desaturation in 41.7%). GAP Stage III was documented in 22.5%. Independent predictors of GAP Stage III included DLCO <35% (aOR 4.1), age ≥65 years (aOR 3.2), and male sex in IPF (aOR 2.0). Conclusion: CTD-ILD is the leading ILD category at this tertiary care hospital. Systematic connective tissue serology — including myositis panel — should be part of all new ILD evaluations. DLCO and 6MWT are the most sensitive functional impairment markers and reliable GAP stage predictors.
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Dr. C.A. Umesh Varma
Assistant Professor, Department of Respiratory Medicine, Aarupadai Veedu Medical College and Hospital, Kirumampakkam, Puducherry – 607402
Dr. A. Vivek Thanga Durai
Associate Professor, Department of Respiratory Medicine Bhaarath Medical College and Hospital, Selaiyur, Chennai
