Interstitial Lung Disease Medical Slides

Present the four key patterns with characteristic features: UIP (basal-predominant honeycombing, traction bronchiectasis, minimal ground-glass), NSIP (basal ground-glass with subpleural sparing), OP (consolidation in peribronchial distribution, reversed halo sign), and HP (upper/mid-zone mosaic attenuation with air trapping). Emphasize that a definite UIP pattern on HRCT has >90% positive predictive value for histological UIP, often avoiding surgical biopsy.

Present the systematic screening panel: ANA (CTD screen), RF and anti-CCP (rheumatoid arthritis), anti-Scl-70 and anti-centromere (scleroderma), anti-Jo-1 and other myositis-specific antibodies (antisynthetase syndrome), ANCA (vasculitis). Include serum KL-6 and SP-D as ILD activity biomarkers. Emphasize that up to 15% of apparently idiopathic ILD is reclassified as CTD-ILD after comprehensive autoimmune evaluation.

Reference the pivotal trials: pirfenidone (ASCEND, 2014) reduced FVC decline by 50% in IPF; nintedanib (INPULSIS, 2014) reduced FVC decline by 50% in IPF. Present the expanding indications — nintedanib for progressive fibrosing ILD (INBUILD trial, 2019) and SSc-ILD (SENSCIS trial). Discuss the 2022 guidelines recommending antifibrotics for progressive pulmonary fibrosis regardless of underlying ILD diagnosis.