Diagnosis of pSS-ILD
High-resolution computed tomography (HRCT) is considered the gold standard for diagnosis of interstitial lung disease (ILD) in primary Sjögren’s syndrome (pSS)1,2
HRCT COMBINED WITH MULTIDISCIPLINARY EVALUATION INCREASE DIAGNOSTIC ACCURACY OF ILD IN PATIENTS WITH pSS3-7
HRCT should be used to confirm or exclude ILD in patients with pSS when there is reason to suspect ILD, according to symptoms, clinical examination, chest radiography or pulmonary function abnormalities.4,7
A multidisciplinary approach, including a rheumatologist, pulmonologist, radiologist and pathologist represents the best strategy to identify signs and symptoms of
Find out more about how to diagnose pSS-ILD using HRCT
Suggested algorithm from consensus guidelines to screen for and identify ILD in patients with pSS7
* The benefit of obtaining baseline PFTs in asymptomatic pSS patients with regards to long-term outcomes is not clear. This paucity of evidence and the potential costs of the test should be taken into account and discussed with individual patients prior to proceeding with screening PFTs.
Complete PFTs includes spirometry, DLCO, lung volumes, ideally measured by body plethysmography.
Adapted from: Lee AS, et al. Chest. 2020 Oct 20. doi: 10.1016/j.chest.2020.10.011.
Once you have reached a diagnosis, how should you manage your patients with pSS-ILD?
Monitoring and management of ILD progression in pSS-ILD
Providing palliative/supportive care
- CXR, chest X-ray; DLCO, diffusing capacity of the lung for carbon monoxide; HRCT, high-resolution computed tomography; interstitial lung disease; PFT, pulmonary function test; pSS, primary Sjögren’s syndrome; pSS-ILD, primary Sjögren’s syndrome-associated interstitial lung disease.
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Lee AS, Scofield RH, Hammitt KM, et al. Consensus guidelines for evaluation and management of pulmonary disease in Sjögren’s. Chest. 2020 Oct 20. doi: 10.1016/j. chest.2020.10.011.
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Maher TM, Wuyts W. Management of Fibrosing Interstitial Lung Diseases. Adv Ther. 2019;doi:10.1007/s12325-019-00992-9. [Epub ahead of print].
Sgalla G, Cerri S, Ferrari R, et al. Mindfulness-based stress reduction in patients with interstitial lung diseases: a pilot, single-centre observational study on safety and efficacy. BMJ Open Respir Res. 2015;2(1):e000065.