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Diagnostic algorithm for evaluation of ILD Part 5 - Dr. Sheetu singh

Diagnostic Algorithm for Evaluation of ILD. Visit our website for more information - www.drsheetusingh.com and book appointment.

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Diagnostic algorithm for evaluation of ILD Part 5 - Dr. Sheetu singh

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  1. ILD: Made easy

  2. 3.52 times risk of developing HP rather than other ILD after bird exposure ILD India Registry: Dr Sheetu Singh

  3. Sharma BB, Singh S, Singh V. Hypersensitivity pneumonitis: the dug-well lung. Allergy Asthma Proc 2013;34:e59-64. ILD India Registry: Dr Sheetu Singh

  4. Laboratory evaluation Peripheral eosinophilia > 10% • Chronic eosinophilic pneumonia • Sarcoidosis Abnormal renal function - Pulmonary-renal syndromes Precipitating antibodies to specific antigens -HP

  5. ANA testing It is recommended to get following tests done for all ILD patients at the onset – • ANA testing (by indirect immunofluorescence) • Rheumatoid factor (RF) • Anti CCP testing Additional serologic testing should be advised in patients with a high pre-test probability for connective tissue disease (CTD)-ILD

  6. RF, ANA, anti-CCP → if positive → Get full collagen panel done • RF/Anti-CCP – Rheumatoid arthritis • ANA/Anti-dsDNA - SLE • Anti Jo1 – Polymyositis / Dermatomyositis • Anti U1RNP – Mixed connective tissue disease • Anti Scl-70 - Scleroderma • Anti SSA, SSB – Sjogren’s syndrome • Angiotensin converting enzyme - Sarcoidosis • ANCA – Granulomatosis with polyangitis

  7. Diagnostic algorithm for evaluation of ILD Cough and Exertionaldyspnoea Chest radiograph, PFT, 6MWT Either reticular/nodular/cystic shadow on CXR OR Restrictive spirometry & diffusion defect OR Desaturation on 6MWT dUIP →IPF CTD-ILD HRCT Chest Confident clinical diagnosis* Sarcoid, HP, PAP, Lymphangitis carcinomatosis Other idiopathic IIP Bronchoscopy BAL, Endobronchial biopsies, TBLB, EBUS-TBNA Open lung or VATS assisted lung biopsy or Transbronchial cryobiopsy If inconclusive

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