3
Table 2. Risk Factors for the Development of ILD Which May
Indicate the Need for Screening
Disease Risk Factors
Systemic sclerosis • Anti-Scl-70 positivity, antinuclear antibody with nucleolar pattern
• Diffuse cutaneous subtype, male sex, African-American race
• Early disease (first 5–7 years after onset)
• Elevated acute phase reactants
Rheumatoid
arthritis
• High titer rheumatoid factor, high titer anti-cyclic citrullinated
peptide (CCP)
• Cigarette smoking, older age at rheumatoid arthritis onset, high
disease activity
• Male sex, higher body mass index
Idiopathic
inflammatory
myopathies
• Anti-synthetase ( Jo-1, PL7, PL12, EJ, OJ, KS, Ha, Zo), anti-
melanoma differentiation-associated protein 5 (MDA-5), anti-Ku,
anti-Pm/Scl, anti-Ro52 antibody positivity
• Mechanic's hands, arthritis/arthralgia, ulcerating lesions
Mixed connective
tissue disease
• Dysphagia, Raynaud phenomenon,
• Other systemic sclerosis clinical or laboratory features
Sjögren's disease • Anti-Ro52 antibody, antinuclear antibody
• Raynaud phenomenon
• Older age
• Lymphopenia
• Severe dental caries
Note: ese disease features have been identified as placing a person at increased risk
for developing ILD. However, the absence of these risk factors does not preclude the
development of ILD in patients with these SARDs. Screening for ILD should be
performed in shared decision-making with the rheumatologist and patient. As such,
screening for ILD should not necessarily be limited only to those with these risk factors.
Screening and Monitoring
