INTERSTITIAL PNEUMONIAE WITH AUTOIMMUNE MANIFESTATIONS. JOINT CONSENSUS OF THE ERS/ATS
Abstract
Some patients with idiopathic interstitial pneumonias (IIPs) have extrathoracic signs and symptoms suggestive for coexisting autoimmune disease that, however, do not meet criteria for any connective tissue disease (CTD). Currently, there are no unique terms and criteria for these cases. The European Respiratory Society and the American Thoracic Society created the Task Force Group on Undifferentiated Forms of CTD Associated with Interstitial Lung Disease in order to develop consensus on terminology and diagnostic criteria for patients with IIP and clinical features of an autoimmune disorder. The Task Force created the term «interstitial pneumonia with autoimmune features (IPAF)» and diagnostic criteria based on three groups of signs: clinical signs including specific clinical extrathoracic features; serological features including specific autoantibodies and morphological features including imaging, histology and respiratory physiology. Experts supposed that the term IPAF should facilitate identification patients with IIP and specific autoimmune signs but without a definitive CTD. This term should also provide involvement a uniform cohort of patients in clinical studies.
References
1. American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. Am. J. Respir. Crit. Care Med. 2002; 165: 277–304.
2. Raghu G., Collard H.R., Egan J.J. et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence based guidelines for diagnosis and man agement. Am. J. Respir. Crit. Care Med. 2011; 183: 788–824.
3. Travis W.D., Costabel U., Hansell D.M. et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am.J. Respir. Crit. Care Med. 2013; 188: 733–748.
4. Park J.H., Kim D.S., Park I.N. et al. Prognosis of fibrotic interstitial pneumonia: idiopathic versus collagen vascular disease related subtypes. Am. J. Respir. Crit. Care Med. 2007; 175: 705–711.
5. Solomon J.J., Chartrand S., Fischer A. Current approach to connective tissue disease associated interstitial lung disease. Curr. Opin. Pulm. Med. 2014; 20: 449–456.
6. Vij R., Strek M.E. Diagnosis and treatment of connective tissue disease associated interstitial lung disease. Chest. 2013; 143: 814–824.
7. Fischer A., du Bois R. Interstitial lung disease in connective tissue disorders. Lancet. 2012; 380: 689–698.
8. Tzelepis G.E., Toya S.P., Moutsopoulos H.M. Occult con nective tissue diseases mimicking idiopathic interstitial pneumonias. Eur. Respir. J. 2008; 31: 11–20.
9. Mittoo S., Gelber A.C., Christopher Stine L. et al. Ascertainment of collagen vascular disease in patients pre senting with interstitial lung disease. Respir. Med. 2009; 103: 1152–1158.
10. Castelino F.V., Varga J. Interstitial lung disease in connective tissue diseases: evolving concepts of pathogenesis and management. Arthritis Res. Ther. 2010; 12: 213.
11. Castelino F.V., Goldberg H., Dellaripa P.F. The impact of rheumatological evaluation in the management of patients with interstitial lung disease. Rheumatology (Oxford). 2011; 50: 489–493.
12. Cottin V. Interstitial lung disease: are we missing formes frustes of connective tissue disease? Eur. Respir. J. 2006; 28: 893–896.
13. Fischer A., Meehan R.T., Feghali Bostwick C.A. et al. Unique characteristics of systemic sclerosis sine scleroder ma associated interstitial lung disease. Chest. 2006; 130: 976–981.
14. Fischer A., Pfalzgraf F.J., Feghali Bostwick C.A. et al. Anti th/to positivity in a cohort of patients with idiopathic pul monary fibrosis. J. Rheumatol. 2006; 33: 1600–1605.
15. Fischer A., Swigris J.J., du Bois R.M. et al. Minor salivary gland biopsy to detect primary Sjogren syndrome in patients with interstitial lung disease. Chest. 2009; 136: 1072–1078.
16. Fischer A., Swigris J.J., du Bois R.M. et al. Anti synthetase syndrome in ANA and anti Jo 1 negative patients presenting with idiopathic interstitial pneumonia. Respir. Med. 2009; 103: 1719–1724.
17. Cottin V. Interstitial lung disease. Eur. Respir. Rev. 2013; 22:26–32.
18. Fischer A., Richeldi L. Cross disciplinary collaboration in connective tissue disease related lung disease. Semin. Respir. Crit. Care Med. 2014; 35: 159–165.
19. Kinder B.W., Collard H.R., Koth L. et al. Idiopathic non specific interstitial pneumonia: lung manifestation of undif ferentiated connective tissue disease? Am. J. Respir. Crit. Care Med. 2007; 176: 691–697.
20. Fischer A., West S.G., Swigris J.J. et al. Connective tissue disease associated interstitial lung disease: a call for clarification. Chest. 2010; 138: 251–256.
21. Vij R., Noth I., Strek M.E. Autoimmune featured interstitial lung disease: a distinct entity. Chest. 2011; 140: 1292–1299.
22. Corte T.J., Copley S.J., Desai S.R. et al. Significance of connective tissue disease features in idiopathic interstitial pneumonia. Eur. Respir. J. 2012; 39: 661–668.
23. LeRoy E.C., Black C., Fleischmajer R. et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J. Rheumatol. 1988; 15: 202–205.
24. LeRoy E.C., Medsger T.A. Jr. Criteria for the classification of early systemic sclerosis. J. Rheumatol. 2001; 28: 1573–1576.
25. Hervier B., Wallaert B., Hachulla E. et al. Clinical manifestations of anti synthetase syndrome positive for anti alanyl tRNA synthetase (anti PL12) antibodies: a retrospective study of 17 cases. Rheumatology (Oxford). 2010; 49: 972–976.
26. Kalluri M., Sahn S.A., Oddis C.V. et al. Clinical profile of anti PL 12 autoantibody. Cohort study and review of the literature. Chest. 2009; 135: 1550–1556.
27. Hirakata M., Suwa A., Takada T. et al. Clinical and immunogenetic features of patients with autoantibodies to asparaginyl transfer RNA synthetase. Arthritis Rheum. 2007; 56: 1295–1303.
28. Kang E.H., Lee E.B., Shin K.C. et al. Interstitial lung dis ease in patients with polymyositis, dermatomyositis and amyopathic dermatomyositis. Rheumatology (Oxford). 2005; 44: 1282–1286.
29. Lega J.C., Cottin V., Fabien N. et al. Interstitial lung disease associated with anti PM/Scl or anti aminoacyl tRNA syn thetase autoantibodies: a similar condition? J. Rheumatol. 2010; 37: 1000–1009.
30. Lega J.C., Fabien N., Reynaud Q. et al. The clinical pheno type associated with myositis specific and associated autoantibodies: A meta analysis revisiting the so called antisynthetase syndrome. Autoimmun. Rev. 2014; 13: 883–891.
31. Targoff I.N., Arnett F.C. Clinical manifestations in patients with antibody to PL 12 antigen (alanyl tRNA synthetase). Am. J. Med. 1990; 88: 241–251.
32. Friedman A.W., Targoff I.N., Arnett F.C. Interstitial lung disease with autoantibodies against aminoacyl tRNA syn thetases in the absence of clinically apparent myositis. Semin. Arthritis Rheum. 1996; 26: 459–467.
33. Herrick A.L. The pathogenesis, diagnosis and treatment of Raynaud phenomenon. Nat. Rev. Rheumatol. 2012; 8: 469–479.
34. Valentini G., Vettori S., Cuomo G. et al. Early systemic sclerosis: short term disease evolution and factors predicting the development of new manifestations of organ involvement. Arthritis Res. Ther. 2012; 14: R188.
35. De Angelis R., Cutolo M., Gutierrez M. et al. Different microvascular involvement in dermatomyositis and systemic sclerosis. A preliminary study by a tight videocapillaroscopic assessment. Clin. Exp. Rheumatol. 2012; 30 (Suppl. 71): S67–S70.
36. Reveille J.D., Solomon D.H. Evidence based guidelines for the use of immunologic tests: anticentromere, Scl 70, and nucleolar antibodies. Arthritis Rheum. 2003; 49: 399–412.
37. Goodwin J.S., Searles R.P., Tung K.S. Immunological responses of healthy elderly population. Clin. Exp. Immunol. 1982; 48: 403–410.
38. Manoussakis M.N., Tzioufas A.G., Silis M.P. et al. High prevalence of anti cardiolipin and other autoantibodies in a healthy elderly population. Clin. Exp. Immunol. 1987; 69: 557–565.
39. Ruffatti A., Rossi L., Calligaro A. et al. Autoantibodies of systemic rheumatic diseases in the healthy elderly. Gerontology. 1990; 36: 104–111.
40. Steen V.D. Autoantibodies in systemic sclerosis. Semin. Arthritis Rheum. 2005; 35: 35–42.
41. Solomon D.H., Kavanaugh A.J., Schur P.H. et al. Evidence-based guidelines for the use of immunologic tests: antinuclear antibody testing. Arthritis Rheum. 2002; 47: 434–444.
42. Shanmugam V.K., Swistowski D.R., Saddic N. Comparison of indirect mmunofluorescence and multiplex antinuclear antibody screening in systemic sclerosis. Clin. Rheumatol. 2011; 30: 1363–1368.
43. Ando M., Miyazaki E., Ishii T. et al. Incidence of myeloperoxidase anti neutrophil cytoplasmic antibody positivity and microscopic polyangitis in the course of idiopathic pulmonary fibrosis. Respir. Med. 2013; 107: 608–615.
44. Tzelepis G.E., Kokosi M., Tzioufas A. et al. Prevalence and outcome of pulmonary fibrosis in microscopic polyangiitis. Eur. Respir. J. 2010; 36: 116–121.
45. Tanaka N., Newell J.D., Brown K.K. et al. Collagen vascular diseaserelated lung disease: high resolution computed tomography findings based on the pathologic classification. J. Comput. Assist. Tomogr. 2004; 28: 351–360.
46. Hwang J.H., Misumi S., Sahin H. et al. Computed tomographic features of idiopathic fibrosing interstitial pneumonia: comparison with pulmonary fibrosis related to collagen vascular disease. J. Comput. Assist. Tomogr. 2009; 33: 410–415.
47. Kim E.J., Elicker B.M., Maldonado F. et al. Usual interstitial pneumonia in rheumatoid arthritis associated interstitial lung disease. Eur. Respir. J. 2010; 35: 1322–1328.
48. Lynch D.A., Travis W.D., Muller N.L. et al. Idiopathic interstitial pneumonias: CT features. Radiology. 2005; 236: 10–21.
49. Travis W.D., Hunninghake G., King T.E. Jr. et al. Idiopathic nonspecific interstitial pneumonia: report of an American Thoracic Society project. Am. J. Respir. Crit. Care Med. 2008; 177: 1338–1347.
50. Fukuoka J.L.K. Practical Pulmonary Pathology. A Diagnostic Approach. Philadelphia: Churchill Livingstone; 2005.
51. Leslie K.O., Trahan S., Gruden J. Pulmonary pathology of the rheumatic diseases. Semin. Respir. Crit. Care Med. 2007; 28: 369–378.
52. Pipavath S.J., Lynch D.A., Cool C. et al. Radiologic and pathologic features of bronchiolitis. Am. J. Roentgenol. 2005; 185: 354–363.
53. White E.S., Tazelaar H.D., Lynch J.P. III. Bronchiolar complications of connective tissue diseases. Semin. Respir. Crit. Care Med. 2003; 24: 543–566.
54. Mosca M., Tani C., Carli L. et al. Undifferentiated CTD: a wide spectrum of autoimmune diseases. Best Pract. Res. Clin. Rheumatol. 2012; 26: 73–77.
55. Mosca M., Tani C., Bombardieri S. Undifferentiated con nective tissue diseases (UCTD): a new frontier for rheu matology. Best Pract. Res. Clin. Rheumatol. 2007; 21: 1011–1023.
56. Mosca M., Neri R., Bencivelli W. et al. Undifferentiated connective tissue disease: analysis of 83 patients with a minimum followup of 5 years. J. Rheumatol. 2002; 29: 2345–2349.
57. Mosca M., Neri R., Bombardieri S. Undifferentiated con nective tissue diseases (UCTD): a review of the literature and a proposal for preliminary classification criteria. Clin. Exp. Rheumatol. 1999; 17: 615–620.
Review
For citations:
INTERSTITIAL PNEUMONIAE WITH AUTOIMMUNE MANIFESTATIONS. JOINT CONSENSUS OF THE ERS/ATS. PULMONOLOGIYA. 2016;26(5):529-538. (In Russ.)
Views:
2929
Email this article 