Hospital Universitario Mayor Méderi, Calle 24 # 29-45, Bogotá, Colombia; Faculty of Medicine, University of Rosario, Calle 12C # 6-25, Bogotá, Colombia.
Fundación Santa fe de Bogotá, Carrera 7 # 117-15, Bogotá, Colombia.
Reumatol Clin (Engl Ed). 2024 Jun-Jul;20(6):334-340. doi: 10.1016/j.reumae.2023.12.010.
Interstitial lung disease is a leading cause of mortality in patients with systemic sclerosis. Currently, there is a lack of consensus regarding screening, rescreening, diagnosis, and follow-up practices in interstitial lung disease associated with systemic sclerosis (SSc-ILD) in Colombia.
A structured survey focused on clinical practices in patients with SSc-ILD was conducted. Members of the Asociación Colombiana de Neumología y Cirugía de Tórax (Asoneumocito) and the Asociación Colombiana de Reumatología (Asoreuma) were invited to participate from March 2023 to May 2023.
We surveyed 51 pulmonologists and 44 rheumatologists. Overall, 51.6% reported having access to multidisciplinary team discussion in ILD. Among the 95 participants, 78.9% would routinely perform a high-resolution computed tomography scan of the chest once a diagnosis of systemic sclerosis was established. This practice is more frequent among rheumatologists (84.1%) than among pulmonologists (74.5%). Approximately half of the participants would rescreen patients annually with computed tomography scan (56.8%) if baseline images were negative. Spirometry (81.1%), diffusing capacity of the lung for carbon monoxide (80.0%), and 6-min walk test (55.8%) were the most frequently performed tests upon diagnosis of systemic sclerosis. During follow-up, participants would consider repeating pulmonary function tests mostly every 6 months.
Screening of SSc-ILD is high among pulmonologists and rheumatologists. Decision-making on diagnosis and follow-up is similar between specialties, but there are variations in their frequency and indications. Further research is needed to evaluate how to adapt recommendations for assessing SSc-ILD in different settings.
间质性肺病是系统性硬化症患者死亡的主要原因。目前，哥伦比亚在系统性硬皮病相关间质性肺病（SSc-ILD）的筛查、重新筛查、诊断和随访实践方面缺乏共识。
我们进行了一项针对 SSc-ILD 患者临床实践的结构化调查。邀请了 Colombian Association of Pulmonology and Thoracic Surgery (Asoneumocito) 和 Colombian Association of Rheumatology (Asoreuma) 的成员自 2023 年 3 月至 2023 年 5 月参加。
我们调查了 51 名肺科医生和 44 名风湿病医生。总体而言，51.6%的人表示可以获得ILD 多学科团队讨论。在 95 名参与者中，78.9%的人一旦确诊系统性硬化症，就会常规进行胸部高分辨率计算机断层扫描。这种做法在风湿病医生中更为常见（84.1%），而在肺科医生中则较为少见（74.5%）。如果基线图像为阴性，约一半的参与者会每年通过计算机断层扫描重新筛查患者（56.8%）。诊断系统性硬化症后，最常进行的检查是肺量测定（81.1%）、一氧化碳弥散量（80.0%）和 6 分钟步行试验（55.8%）。在随访期间，参与者主要每 6 个月考虑重复进行肺功能检查。
肺科医生和风湿病医生对 SSc-ILD 的筛查率较高。在诊断和随访方面，各专业之间的决策相似，但在频率和适应症方面存在差异。需要进一步研究来评估如何在不同环境中调整评估 SSc-ILD 的建议。
