Interstitial Lung Disease for the Rheumatologist: Pearls and Insights

Authors

  • Laurence Poirier-Blanchette, MD, FRCPC Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montréal, Quebec
  • Océane Landon-Cardinal, MD, FRCPC Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montréal, Quebec
  • Sabrina Hoa, MD, MSc, FRCPC Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montréal, Quebec Arthritis Research Canada

DOI:

https://doi.org/10.58931/crt.2025.2366

Abstract

Interstitial lung disease (ILD) is a potentially life-threatening complication of systemic autoimmune rheumatic diseases (SARDs). Its prevalence varies according to the underlying SARD, being highest in anti-synthetase and anti‑melanoma-differentiation-associated protein 5 (MDA5) syndromes, but affecting the greatest number of individuals in rheumatoid arthritis due to its higher overall frequency.  Because ILD onset may precede, coincide with, or follow SARD diagnosis, rheumatologists may uncover an undiagnosed SARD during ILD evaluation or, conversely, detect ILD through screening of patients with established SARD. The spectrum of SARD-ILD is broad: some patients have mild, stable disease, others experience slowly progressive disease, and some deteriorate rapidly despite treatment, leading to oxygen dependence, lung transplantation, or death. Drug therapies, including immunosuppressive and anti‑fibrotic agents, can slow the progression of SARD-ILD.

This article addresses three key clinical questions pertinent to rheumatologists. First, we explore clinical, serological, and morphological features that can aid in diagnosing SARD in patients with ILD, offering practical pearls. Second, we examine screening—covering who to screen, when, how, and at what frequency. Finally, we outline our approach to SARD-ILD management.

Author Biographies

Laurence Poirier-Blanchette, MD, FRCPC, Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montréal, Quebec

Dr. Laurence Poirier-Blanchette is a rheumatologist and postdoctoral fellow specializing in scleroderma and systemic autoimmune rheumatic diseases‑associated interstitial lung disease (ILD). She completed her medical degree at the Université de Montréal, her core internal medicine training at McGill University, and her rheumatology residency at the Université de Montréal.

Océane Landon-Cardinal, MD, FRCPC, Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montréal, Quebec

Dr. Océane Landon-Cardinal is a rheumatologist, associate professor, and clinician scientist at the Centre hospitalier de l’Université de Montréal (CHUM). She is the director of the CHUM Myositis Clinic and an active member of the multidisciplinary interstitial lung disease (ILD) clinic at the CHUM. Her research focuses on the clinico-sero-pathological characterization of autoimmune myositis subsets, with a specific interest in overlap myositis associated with ILD.

Sabrina Hoa, MD, MSc, FRCPC, Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montréal, Quebec Arthritis Research Canada

Dr. Sabrina Hoa is a rheumatologist, associate professor, and clinician scientist at the Centre hospitalier de l’Université de Montréal (CHUM). She directs the Scleroderma Clinic at the CHUM and holds the Université de Montréal Scleroderma Research Chair. She is also an active member of the multidisciplinary interstitial lung disease (ILD) at the CHUM. Her research focuses on systemic sclerosis‑associated ILD and on the role of early immunosuppression in the prevention of damage.

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2025-12-19

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Poirier-Blanchette L, Landon-Cardinal O, Hoa S. Interstitial Lung Disease for the Rheumatologist: Pearls and Insights. Can Rheumatol Today [Internet]. 2025 Dec. 19 [cited 2025 Dec. 23];2(3):4–13. Available from: https://canadianrheumatologytoday.com/article/view/2-3-Poirier-Blanchette_et_al

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