Lodin Karin, Notarnicola Antonella, Dastmalchi Maryam, Dani Lara, Mari Svensson Ann, Rönnelid Johan, Sköld Magnus, E Lundberg Ingrid
ST-läkare, Älvsjö vårdcentral.
med dr, specialistläkare, institutionen för medicin, Karolinska institutet, Solna.
Lakartidningen. 2022 Aug 8;119:22023.
Interstitial lung disease can be the first sign of systemic autoimmune disease. If associated with myositis, interstitial lung disease may be the only symptom, with no presence of muscular weakness or other extramuscular manifestations. ANA-testing performed with indirect immune fluorescence may be negative. Testing for myositis antibodies should be considered as a step in the diagnostic process when strong clinical suspicion of interstitial lung disease of unknown origin is present. If interstitial lung disease is suspected, the patients should be referred to a specialist clinic for further investigation and, if possible, for discussion within a multidisciplinary team. Early suspicion of systemic inflammatory disease, rapid diagnosis and early start of treatment are crucial for future prognosis, quality of life and survival.
间质性肺病可能是系统性自身免疫性疾病的首发症状。若与肌炎相关,间质性肺病可能是唯一症状,不存在肌肉无力或其他肌肉外表现。采用间接免疫荧光法进行的抗核抗体检测可能呈阴性。当临床上高度怀疑存在不明原因的间质性肺病时,应考虑检测肌炎抗体作为诊断过程的一个步骤。若怀疑患有间质性肺病,患者应转诊至专科门诊进行进一步检查,并尽可能在多学科团队内进行讨论。早期怀疑系统性炎症性疾病、快速诊断及尽早开始治疗对未来的预后、生活质量和生存率至关重要。