How does CTD-ILD treat? The 2018 edition of the Expert Consensus is read out.

To help standardize the clinical diagnosis and treatment of ctd-ild in China, and improve the prognosis and quality of life of ctd-ild patients.interstitial lung disease (ILD) is a common pulmonary complication in patients with connective tissue disease (CTD).ctd-ild can be seen in a variety of CTD, such as systemic sclerosis (SSC), polymyositis / dermatomyositis (PM / DM), rheumatoid arthritis (RA), Sjogren's syndrome (SS) and systemic lupus erythematosus (SLE). The prevalence of ctd-ild varies from 3% to 70% due to different detection methods Development and outcome lead to difficulties in diagnosis and treatment.in order to improve doctors' understanding of connective tissue-related ILD, standardize the clinical diagnosis and treatment of ctd-ild in China, advocate early screening, early diagnosis and early intervention, pay attention to patient follow-up and management, and ultimately improve the prognosis and quality of life of ctd-ild patients Based on the international and domestic clinical diagnosis and treatment experience and evidence, the consensus was formulated by experts from multiple disciplines such as science.the consensus includes: 1) three primary principles for the diagnosis and treatment of ctd-ild; 2) seven recommendations; 3) six urgent issues.this issue focuses on the contents of disease screening, diagnosis and disease progress evaluation.01. First principles of ctd-ild diagnosis and treatment. Because ctd-ild is complex and difficult to treat, Chinese experts have determined three primary principles in the diagnosis and treatment of ctd-ild, emphasizing the importance of multidisciplinary diagnosis and treatment, and suggesting doctors and patients to participate in the development of optimal treatment and follow-up strategies.2. Seven recommendations for the diagnosis and treatment of ctd-ild. The screening strategy of ctd-ild is divided into the following two aspects: screening objects and recommendations for follow-up interval time: common clinical symptoms, signs and detection methods for ILD and CTD screening: rheumatologists and respiratory physicians respectively diagnose CTD and ILD according to the corresponding international standards.compared with chest X-ray film and common CT, chest HRCT can improve the sensitivity of ILD diagnosis, which is very important for ILD diagnosis.the common histopathological and chest HRCT imaging features of ctd-ild are as follows: the benefits of bronchoalveolar lavage fluid cytology and lung biopsy are still controversial; although lung biopsy is the gold standard for the diagnosis of ILD, the benefit of surgical lung biopsy in patients with confirmed ctd-ild has always been controversial because of its invasive nature and the possibility of exacerbation.evaluation of disease activity of CTD: it is mainly based on the overall activity evaluation system recognized by each CTD, but there is no recognized disease activity evaluation tool for some CTD (such as undifferentiated CTD and mixed CTD), so rheumatologists need to reflect through the whole body assessment (PAG) of clinicians.ILD evaluation includes not only the assessment of the severity of lung function damage, but also the judgment of the reversibility of ILD treatment, and more importantly, the prediction of fibrosis progression.it should be emphasized that physicians from respiratory department and imaging department should participate in the comprehensive evaluation of ILD, including pulmonary function, chest high-resolution CT and arterial blood gas assessment.ctd-ild related treatment and long-term management will be explained in the next issue, please look forward to it! References: rheumatology related pulmonary vascular / interstitial disease group of Rheumatology and Immunology branch of Chinese Medical Doctor Association, etc. Chinese Journal of internal medicine. 2018; 57 (8): 558-565-end - love me, please give me a good look!