PO59 - Impact of Rheumatologist Involvement on Diagnostic and Treatment Optimization in Interstitial Lung Disease
Tiago Antunes de Sá (Portugal)1; Teresa Machado (Portugal)1; Luís Lázaro (Portugal)1; Eduarda Tinoco (Portugal)1; Cristina Alves (Portugal)1; Carla Nogueira (Portugal)1; Patrícia Pinto (Portugal)2; Ana Ribeiro (Portugal)3; Célia Sousa (Portugal)4; Inês Marques (Portugal)4; Sérgio Campainha (Portugal)1; Sofia Neves (Portugal)1;
1 - Serviço de Pneumologia - Unidade Local de Saúde Gaia-Espinho; 2 - Serviço de Reumatologia - Unidade Local de Saúde Gaia-Espinho; 3 - Serviço de Anatomia Patológica - Unidade Local de Saúde Gaia-Espinho; 4 - Serviço de Imagiologia - Unidade Local de Saúde Gaia-Espinho;
Keywords: ILD Diagnosis; Reumathology; Multidisciplinary Team;
Select the theme: Genetics and Immunopathology: Advances in Contemporary Understanding and Prospects for Future Research
Type: Original Papers
Presentation: Poster Presentation

Introduction: Multidisciplinary team (MDT) discussion is the gold standard for Interstitial Lung Disease (ILD) diagnosis. However, despite the significant prevalence of systemic autoimmune rheumatic diseases (SARD), rheumatologists are frequently not included in core MDTs or considered an essential specialty for its initial assembly. Their exclusion often leads to the underdiagnosis of connective tissue diseases (CTD) or the misclassification of idiopathic forms.

Objectives: To evaluate the clinical impact of rheumatological participation in an ILD-MDT regarding diagnostic reclassification, the nature of clinical queries and therapeutic modifications.

Materials and Methods: This retrospective study analyzed 89 patients discussed in a specialized ILD-MDT with rheumatological integration between August 2024 and March 2026. We quantified referral diagnoses, individual clinical query events (counted separately when multiple issues were raised per patient), diagnostic outcomes and therapeutic changes.

Results: A total of 89 patients were evaluated. The MDT addressed 98 individual clinical query events, primarily "suspected CTD-ILD" (n=50) and "therapeutic change/adjustment" (n=32). Following the meeting, the diagnosis was clarified or modified in 38 patients (42.7%). New specific diagnoses included Sjögren’s Syndrome, Rheumatoid Arthritis, Systemic Sclerosis, Antisynthetase Syndrome, ANCA-associated Vasculitis and IgG4-Related Disease. Furthermore, therapeutic modifications were implemented in 41 patients (46.1%), involving the initiation of mycophenolate mofetil, rituximab, nintedanib, or adjustment of corticosteroid doses.

Notably, in 10 patients (11.2%), the MDT excluded CTD-ILD but confirmed the presence of a standalone autoimmune disease.


Conclusions: Our findings emphasize that Rheumatology is a vital component of the ILD-MDT, despite its frequent absence from core specialty lists. Integration is essential for refining diagnostic accuracy in nearly half of the cases and ensuring tailored therapeutic interventions, thereby preventing irreversible lung damage.