S1-Leitlinie Interdisziplinäre Diagnostik interstitieller Lungenerkrankungen im Erwachsenenalter

 

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Zusammenfassung

Die Beurteilung von Patienten mit v. a. einer interstitiellen Lungenerkrankung (ILD) umfasst die Beurteilung klinischer, radiologischer und oft histopathologischer Daten. Da bislang noch keine dezidierten Empfehlungen für die Evaluation bei Verdacht auf eine ILD in Deutschland existierten, war es Ziel dieses interdisziplinären Konsensusstatements, eine praktische Orientierungshilfe für den klinischen Alltag in Bezug auf die interdisziplinäre Diagnostik der ILDs zu geben. Dazu gehören die umfassende klinisch-pneumologische und in vielen Fällen auch eine rheumatologische Beurteilung, radiologische Diagnostik sowie Probenentnahme zur histopathologischen Evaluation sowie die abschließende Diskussion im multidisziplinären Team.

Abstract

The evaluation of a patient with interstitial lung disease (ILD) includes assessment of clinical, radiological, and often histopathological data. As there were no specific recommendations to guide the evaluation of patients under the suspicion of an ILD within the German practice landscape, this position statement from an interdisciplinary panel of ILD experts provides guidance related to the diagnostic modalities which should be used in the evaluation of ILD. This includes clinical assessment rheumatological evaluation, radiological examinations, histopathologic sampling and the need for a final discussion in a multidisciplinary team.

Publication History

Article published online:
28 March 2023

© 2023. Thieme. All rights reserved.

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• Literatur

• 1 Doyle TJ, Dellaripa PF. Lung Manifestations in the Rheumatic Diseases. Chest 2017; 152: 1283-1295 DOI: 10.1016/j.chest.2017.05.015.
  CrossrefPubMedGoogle Scholar
• 2 Wijsenbeek M, Cottin V. Spectrum of Fibrotic Lung Diseases. N Engl J Med 2020; 383: 958-968 DOI: 10.1056/NEJMra2005230.
  CrossrefPubMedGoogle Scholar
• 3 Fischer A, Strek ME, Cottin V. et al. Proceedings of the American College of Rheumatology/Association of Physicians of Great Britain and Ireland Connective Tissue Disease-Associated Interstitial Lung Disease Summit: A Multidisciplinary Approach to Address Challenges and Opportunities. Arthritis Rheumatol 2019; 71: 182-195 DOI: 10.1002/art.40769.
  CrossrefPubMedGoogle Scholar
• 4 Behr J, Prasse A, Wirtz H. et al. Survival and course of lung function in the presence or absence of antifibrotic treatment in patients with idiopathic pulmonary fibrosis: long-term results of the INSIGHTS-IPF registry. Eur Respir J 2020; 56: 1902279 DOI: 10.1183/13993003.02279-2019.
  CrossrefPubMedGoogle Scholar
• 5 Bouros D, Wells AU, Nicholson AG. et al. Histopathologic subsets of fibrosing alveolitis in patients with systemic sclerosis and their relationship to outcome. Am J Respir Crit Care Med 2002; 165: 1581-1586 DOI: 10.1164/rccm.2106012.
  CrossrefPubMedGoogle Scholar
• 6 Hoffmann-Vold AM, Allanore Y, Alves M. et al. Progressive interstitial lung disease in patients with systemic sclerosis-associated interstitial lung disease in the EUSTAR database. Ann Rheum Dis 2021; 80: 219-227 DOI: 10.1136/annrheumdis-2020-217455.
  CrossrefPubMedGoogle Scholar
• 7 Hoffmann-Vold AM, Fretheim H, Halse AK. et al. Tracking Impact of Interstitial Lung Disease in Systemic Sclerosis in a Complete Nationwide Cohort. Am J Respir Crit Care Med 2019; 200: 1258-1266 DOI: 10.1164/rccm.201903-0486OC.
  CrossrefPubMedGoogle Scholar
• 8 Steen VD, Conte C, Owens GR. et al. Severe restrictive lung disease in systemic sclerosis. Arthritis Rheum 1994; 37: 1283-1289 DOI: 10.1002/art.1780370903.
  CrossrefPubMedGoogle Scholar
• 9 Distler O, Highland KB, Gahlemann M. et al. Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease. N Engl J Med 2019; 380: 2518-2528 DOI: 10.1056/NEJMoa1903076.
  CrossrefPubMedGoogle Scholar
• 10 Fischer A, Swigris JJ, Groshong SD. et al. Clinically significant interstitial lung disease in limited scleroderma: histopathology, clinical features, and survival. Chest 2008; 134: 601-605 DOI: 10.1378/chest.08-0053.
  CrossrefPubMedGoogle Scholar
• 11 Distler O, Volkmann ER, Hoffmann-Vold AM. et al. Current and future perspectives on management of systemic sclerosis-associated interstitial lung disease. Expert Rev Clin Immunol 2019; 15: 1009-1017 DOI: 10.1080/1744666x.2020.1668269.
  CrossrefPubMedGoogle Scholar
• 12 Winstone TA, Assayag D, Wilcox PG. et al. Predictors of mortality and progression in scleroderma-associated interstitial lung disease: a systematic review. Chest 2014; 146: 422-436 DOI: 10.1378/chest.13-2626.
  CrossrefPubMedGoogle Scholar
• 13 Distler O, Assassi S, Cottin V. et al. Predictors of progression in systemic sclerosis patients with interstitial lung disease. Eur Respir J 2020; 55: 1902026 DOI: 10.1183/13993003.02026-2019.
  CrossrefPubMedGoogle Scholar
• 14 Schinke S, Riemekasten G. [Systemic sclerosis]. Internist (Berl) 2019; 60: 1251-1269 DOI: 10.1007/s00108-019-00699-7.
  CrossrefPubMedGoogle Scholar
• 15 van den Hoogen F, Khanna D, Fransen J. et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis 2013; 72: 1747-1755 DOI: 10.1136/annrheumdis-2013-204424.
  CrossrefPubMedGoogle Scholar
• 16 Kelly CA, Saravanan V, Nisar M. et al. Rheumatoid arthritis-related interstitial lung disease: associations, prognostic factors and physiological and radiological characteristics – a large multicentre UK study. Rheumatology 2014; 53: 1676-1682 DOI: 10.1093/rheumatology/keu165.
  CrossrefPubMedGoogle Scholar
• 17 Duarte AC, Porter JC, Leandro MJ. The lung in a cohort of rheumatoid arthritis patients—an overview of different types of involvement and treatment. Rheumatology 2019; 58: 2031-2038 DOI: 10.1093/rheumatology/kez177.
  CrossrefPubMedGoogle Scholar
• 18 Gabbay E, Tarala R, Will R. et al. Interstitial lung disease in recent onset rheumatoid arthritis. Am J Respir Crit Care Med 1997; 156: 528-535 DOI: 10.1164/ajrccm.156.2.9609016.
  CrossrefPubMedGoogle Scholar
• 19 Kim EJ, Collard HR, King TE. et al. Rheumatoid arthritis-associated interstitial lung disease: the relevance of histopathologic and radiographic pattern. Chest 2009; 136: 1397-1405 DOI: 10.1378/chest.09-0444.
  CrossrefPubMedGoogle Scholar
• 20 Strand MJ, Sprunger D, Cosgrove GP. et al. Pulmonary function and survival in idiopathic vs secondary usual interstitial pneumonia. Chest 2014; 146: 775-785 DOI: 10.1378/chest.13-2388.
  CrossrefPubMedGoogle Scholar
• 21 Bongartz T, Nannini C, Medina-Velasquez YF. et al. Incidence and mortality of interstitial lung disease in rheumatoid arthritis: a population-based study. Arthritis Rheum 2010; 62: 1583-1591 DOI: 10.1002/art.27405.
  CrossrefPubMedGoogle Scholar
• 22 Giles JT, Danoff SK, Sokolove J. et al. Association of fine specificity and repertoire expansion of anticitrullinated peptide antibodies with rheumatoid arthritis associated interstitial lung disease. Ann Rheum Dis 2014; 73: 1487-1494 DOI: 10.1136/annrheumdis-2012-203160.
  CrossrefPubMedGoogle Scholar
• 23 Zamora-Legoff JA, Krause ML, Crowson CS. et al. Patterns of interstitial lung disease and mortality in rheumatoid arthritis. Rheumatology (Oxford) 2017; 56: 344-350 DOI: 10.1093/rheumatology/kew391.
  CrossrefPubMedGoogle Scholar
• 24 Duarte AC, Sousa S, Cordeiro A. et al. FRI0138 Lung involvement in rheumatoid arthritis – a portuguese reality. Annals of the Rheumatic Diseases 2017; 76: 533 DOI: 10.1136/annrheumdis-2017-eular.4513.
  CrossrefPubMedGoogle Scholar
• 25 Barba T, Mainbourg S, Nasser M. et al. Lung Diseases in Inflammatory Myopathies. Semin Respir Crit Care Med 2019; 40: 255-270 DOI: 10.1055/s-0039-1685187.
  Article in Thieme ConnectPubMedGoogle Scholar
• 26 Marie I, Hatron PY, Dominique S. et al. Short-term and long-term outcomes of interstitial lung disease in polymyositis and dermatomyositis: a series of 107 patients. Arthritis Rheum 2011; 63: 3439-3447 DOI: 10.1002/art.30513.
  CrossrefPubMedGoogle Scholar
• 27 Marie I, Josse S, Hatron PY. et al. Interstitial lung disease in anti-Jo-1 patients with antisynthetase syndrome. Arthritis Care Res (Hoboken) 2013; 65: 800-808 DOI: 10.1002/acr.21895.
  CrossrefPubMedGoogle Scholar
• 28 Bauhammer J, Fiehn C. Antisynthetasesyndrome. Zeitschrift für Rheumatologie 2019; 78: 645-655 DOI: 10.1007/s00393-019-0665-0.
  CrossrefPubMedGoogle Scholar
• 29 Chen Z, Cao M, Plana MN. et al. Utility of anti-melanoma differentiation-associated gene 5 antibody measurement in identifying patients with dermatomyositis and a high risk for developing rapidly progressive interstitial lung disease: a review of the literature and a meta-analysis. Arthritis Care Res (Hoboken) 2013; 65: 1316-1324 DOI: 10.1002/acr.21985.
  CrossrefPubMedGoogle Scholar
• 30 Csernok E, Hellmich B. ANCA-Diagnostik bei Vaskulitiden. Zeitschrift für Rheumatologie 2020; 79: 669-678 DOI: 10.1007/s00393-020-00805-3.
  CrossrefPubMedGoogle Scholar
• 31 Bossuyt X, Cohen Tervaert JW, Arimura Y. et al. Position paper: Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis. Nat Rev Rheumatol 2017; 13: 683-692 DOI: 10.1038/nrrheum.2017.140.
  CrossrefPubMedGoogle Scholar
• 32 Jennette JC, Falk R, Bacon P. et al. 2012 revised international chapel hill consensus conference nomenclature of vasculitides. Arthritis Rheum 2013; 65: 1-11 DOI: 10.1002/art.37715.
  CrossrefPubMedGoogle Scholar
• 33 Schirmer JH, Aries PM, de Groot K. et al. S1-Leitlinie Diagnostik und Therapie der ANCA-assoziierten Vaskulitiden. Zeitschrift für Rheumatologie 2017; 76: 77-104
  CrossrefPubMedGoogle Scholar
• 34 Comarmond C, Crestani B, Tazi A. et al. Pulmonary fibrosis in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis: a series of 49 patients and review of the literature. Medicine (Baltimore) 2014; 93: 340-349 DOI: 10.1097/md.0000000000000217.
  CrossrefPubMedGoogle Scholar
• 35 Arulkumaran N, Periselneris N, Gaskin G. et al. Interstitial lung disease and ANCA-associated vasculitis: a retrospective observational cohort study. Rheumatology (Oxford) 2011; 50: 2035-2043 DOI: 10.1093/rheumatology/ker236.
  CrossrefPubMedGoogle Scholar
• 36 Schirmer JH, Wright MN, Vonthein R. et al. Clinical presentation and long-term outcome of 144 patients with microscopic polyangiitis in a monocentric German cohort. Rheumatology (Oxford) 2016; 55: 71-79 DOI: 10.1093/rheumatology/kev286.
  CrossrefPubMedGoogle Scholar
• 37 Moiseev S, Cohen Tervaert JW, Arimura Y. et al. 2020 international consensus on ANCA testing beyond systemic vasculitis. Autoimmun Rev 2020; 19: 102618 DOI: 10.1016/j.autrev.2020.102618.
  CrossrefPubMedGoogle Scholar
• 38 Hooper C, Lee YC, Maskell N. Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010; 65 (Suppl. 02) ii4-17 DOI: 10.1136/thx.2010.136978.
  CrossrefPubMedGoogle Scholar
• 39 Hannah JR, D'Cruz DP. Pulmonary Complications of Systemic Lupus Erythematosus. Semin Respir Crit Care Med 2019; 40: 227-234 DOI: 10.1055/s-0039-1685537.
  Article in Thieme ConnectPubMedGoogle Scholar
• 40 Mittoo S, Fell CD. Pulmonary manifestations of systemic lupus erythematosus. Semin Respir Crit Care Med 2014; 35: 249-254 DOI: 10.1055/s-0034-1371537.
  Article in Thieme ConnectPubMedGoogle Scholar
• 41 Inoue T, Kanayama Y, Ohe A. et al. Immunopathologic studies of pneumonitis in systemic lupus erythematosus. Ann Intern Med 1979; 91: 30-34 DOI: 10.7326/0003-4819-91-1-30.
  CrossrefPubMedGoogle Scholar
• 42 Keane MP, Lynch JP. Pleuropulmonary manifestations of systemic lupus erythematosus. Thorax 2000; 55: 159-166 DOI: 10.1136/thorax.55.2.159.
  CrossrefPubMedGoogle Scholar
• 43 Ugarte-Gil MF, González LA, Alarcón GS. Lupus: the new epidemic. Lupus 2019; 28: 1031-1050 DOI: 10.1177/0961203319860907.
  CrossrefPubMedGoogle Scholar
• 44 Flament T, Bigot A, Chaigne B. et al. Pulmonary manifestations of Sjögren's syndrome. Eur Respir Rev 2016; 25: 110-123 DOI: 10.1183/16000617.0011-2016.
  CrossrefPubMedGoogle Scholar
• 45 Kreider M, Highland K. Pulmonary involvement in Sjögren syndrome. Semin Respir Crit Care Med 2014; 35: 255-264 DOI: 10.1055/s-0034-1371529.
  Article in Thieme ConnectPubMedGoogle Scholar
• 46 Mira-Avendano I, Abril A, Burger CD. et al. Interstitial Lung Disease and Other Pulmonary Manifestations in Connective Tissue Diseases. Mayo Clin Proc 2019; 94: 309-325 DOI: 10.1016/j.mayocp.2018.09.002.
  CrossrefPubMedGoogle Scholar
• 47 Parambil JG, Myers JL, Lindell RM. et al. Interstitial lung disease in primary Sjögren syndrome. Chest 2006; 130: 1489-1495 DOI: 10.1378/chest.130.5.1489.
  CrossrefPubMedGoogle Scholar
• 48 Reina D, Roig Vilaseca D, Torrente-Segarra V. et al. Sjögrenʼs syndrome-associated interstitial lung disease: A multicenter study. Reumatol Clin 2016; 12: 201-205 DOI: 10.1016/j.reuma.2015.09.003.
  CrossrefPubMedGoogle Scholar
• 49 Tani C, Carli L, Vagnani S. et al. The diagnosis and classification of mixed connective tissue disease. J Autoimmun 2014; 48-49: 46-49 DOI: 10.1016/j.jaut.2014.01.008.
  CrossrefPubMedGoogle Scholar
• 50 Ungprasert P, Crowson CS, Chowdhary VR. et al. Epidemiology of Mixed Connective Tissue Disease, 1985–2014: A Population-Based Study. Arthritis Care Res (Hoboken) 2016; 68: 1843-1848 DOI: 10.1002/acr.22872.
  CrossrefPubMedGoogle Scholar
• 51 Gunnarsson R, Aaløkken TM, Molberg Ø. et al. Prevalence and severity of interstitial lung disease in mixed connective tissue disease: a nationwide, cross-sectional study. Ann Rheum Dis 2012; 71: 1966-1972 DOI: 10.1136/annrheumdis-2011-201253.
  CrossrefPubMedGoogle Scholar
• 52 Fagundes MN, Caleiro MT, Navarro-Rodriguez T. et al. Esophageal involvement and interstitial lung disease in mixed connective tissue disease. Respir Med 2009; 103: 854-860 DOI: 10.1016/j.rmed.2008.12.018.
  CrossrefPubMedGoogle Scholar
• 53 Li H, Xiong Z, Liu J. et al. [Manifestations of the connective tissue associated interstitial lung disease under high resolution computed tomography]. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2017; 42: 934-939 DOI: 10.11817/j.issn.1672-7347.2017.08.010.
  CrossrefPubMedGoogle Scholar
• 54 Hajas A, Szodoray P, Nakken B. et al. Clinical course, prognosis, and causes of death in mixed connective tissue disease. J Rheumatol 2013; 40: 1134-1142 DOI: 10.3899/jrheum.121272.
  CrossrefPubMedGoogle Scholar
• 55 Blanc PD, Annesi-Maesano I, Balmes JR. et al. The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement. Am J Respir Crit Care Med 2019; 199: 1312-1334 DOI: 10.1164/rccm.201904-0717ST.
  CrossrefPubMedGoogle Scholar
• 56 Müller-Lisse U. Grundlagen der Röntgendiagnostik des Thorax mit CT-Korrelation einzelner Fälle. Kapitel 1.11. Pneumologie – Lehrbuch für Atmungstherapeuten Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin. Berlin: 2016: 107-121
  Google Scholar
• 57 Nowak D, Ochmann U, Mueller-Lisse UG. Berufskrankheiten der Atemwege und der Lunge. Der Internist 2021; 62: 906-920
  CrossrefPubMedGoogle Scholar
• 58 Hering K, Hofmann-Preiß K, Kraus T. Update: Standardisierte CT-/HRCT-Klassifikation der Bundesrepublik Deutschland für arbeits-und umweltbedingte Thoraxerkrankungen. Der Radiologe 2014; 54: 363-384
  CrossrefPubMedGoogle Scholar
• 59 Hering K, Hofmann-Preiß K. Pneumokoniosen erkennen und klassifizieren. Der Radiologe 2014; 54: 1189-1198
  CrossrefPubMedGoogle Scholar
• 60 Hansell DM, Bankier AA, MacMahon H. et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008; 246: 697
  CrossrefPubMedGoogle Scholar
• 61 Wormanns D, Hamer O. Glossar thoraxradiologischer Begriffe entsprechend der Terminologie der Fleischner Society. RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. Stuttgart: Thieme; 2015: 638-661
  Google Scholar
• 62 Yang M, Wang D, Gan S. et al. Increasing incidence of asbestosis worldwide, 1990–2017: results from the Global Burden of Disease study 2017. Thorax 2020; 75: 798-800
  CrossrefPubMedGoogle Scholar
• 63 Hoy RF, Chambers DC. Silica‐related diseases in the modern world. Allergy 2020; 75: 2805-2817
  CrossrefPubMedGoogle Scholar
• 64 Quirce S, Vandenplas O, Campo P. et al. Occupational hypersensitivity pneumonitis: an EAACI position paper. Allergy 2016; 71: 765-779
  CrossrefPubMedGoogle Scholar
• 65 Klimek L, Vogelberg C, Werfel T. Weißbuch Allergie in Deutschland. Heidelberg: Springer; 2018
  Google Scholar
• 66 Sennekamp J, Müller-Wening D, Amthor M. et al. Empfehlungen zur Diagnostik der exogen-allergischen Alveolitis. Pneumologie 2007; 61: 52-56
  Article in Thieme ConnectPubMedGoogle Scholar
• 67 Kumar A, Cummings KJ. Pulmonary alveolar proteinosis secondary to occupational exposure. Current Pulmonology Reports 2021; 10: 30-39
  CrossrefPubMedGoogle Scholar
• 68 Hubbs AF, Kreiss K, Cummings KJ. et al. Flavorings-related lung disease: a brief review and new mechanistic data. Toxicol Pathol 2019; 47: 1012-1026
  CrossrefPubMedGoogle Scholar
• 69 Kern D, Crausman R. Flock worker’s lung. Uptodate; 2020 https://uptodate.com
  PubMedGoogle Scholar
• 70 Lacasse Y, Selman M, Costabel U. et al. Clinical diagnosis of hypersensitivity pneumonitis. Am J Respir Crit Care Med 2003; 168: 952-958
  CrossrefPubMedGoogle Scholar
• 71 Raghu G, Remy-Jardin M, Ryerson CJ. et al. Diagnosis of hypersensitivity pneumonitis in adults. An official ATS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 2020; 202: e36-e69
  CrossrefPubMedGoogle Scholar
• 72 Lee T, Wraith D, Bennett C. et al. Budgerigar fancierʼs lung: The persistence of budgerigar precipitins and the recovery of lung function after cessation of avian exposure. Clin Allergy 1983; 13: 197-202
  CrossrefPubMedGoogle Scholar
• 73 McSharry C, Dye GM, Ismail T. et al. Quantifying serum antibody in bird fanciersʼ hypersensitivity pneumonitis. BMC Pulm Med 2006; 6: 16
  CrossrefPubMedGoogle Scholar
• 74 Salisbury ML, Myers JL, Belloli EA. et al. Diagnosis and treatment of fibrotic hypersensitivity pneumonia. Where we stand and where we need to go. Am J Respir Crit Care Med 2017; 196: 690-699
  CrossrefPubMedGoogle Scholar
• 75 Cormier Y, Bélanger J, Durand P. Factors influencing the development of serum precipitins to farmerʼs lung antigen in Quebec dairy farmers. Thorax 1985; 40: 138-142
  CrossrefPubMedGoogle Scholar
• 76 Cormier Y, Letourneau L, Racine G. Significance of precipitins and asymptomatic lymphocytic alveolitis: a 20‐yr follow-up. Eur Respir J 2004; 23: 523-525
  CrossrefPubMedGoogle Scholar
• 77 Fenoglio C-M, Reboux G, Sudre B. et al. Diagnostic value of serum precipitins to mould antigens in active hypersensitivity pneumonitis. Eur Respir J 2007; 29: 706-712
  CrossrefPubMedGoogle Scholar
• 78 Raulf M, Joest M, Sander I. et al. Update of reference values for IgG antibodies against typical antigens of hypersensitivity pneumonitis. Allergo Journal International 2019; 28: 192-203
  CrossrefPubMedGoogle Scholar
• 79 Harari S, Wells AU, Wuyts WA. et al. The 6-min walk test as a primary end-point in interstitial lung disease. Eur Respir Rev 2022; 31: 220087
  CrossrefPubMedGoogle Scholar
• 80 Kabitz H, Windisch W. Respiratory muscle testing: state of the art. Pneumologie 2007; 61: 582-587
  PubMedGoogle Scholar
• 81 Windisch W, Dreher M, Geiseler J. et al. S2k-leitlinie: Nichtinvasive und invasive Beatmung als Therapie der chronischen respiratorischen Insuffizienz – Revision 2017. Pneumologie 2017; 71: 722-795
  Article in Thieme ConnectPubMedGoogle Scholar
• 82 Kreuter M, Müller-Ladner U, Costabel U. et al. The diagnosis and treatment of pulmonary fibrosis. Dtsch Arztebl Int 2021; 118: 152-162
  CrossrefPubMedGoogle Scholar
• 83 Schiza S, Mermigkis C, Margaritopoulos GA. et al. Idiopathic pulmonary fibrosis and sleep disorders: no longer strangers in the night. Eur Respir Rev 2015; 24: 327-339
  CrossrefPubMedGoogle Scholar
• 84 Dreher M, Ekkernkamp E, Schmoor C. et al. Pulmonary rehabilitation and noninvasive ventilation in patients with hypercapnic interstitial lung disease. Respiration 2015; 89: 208-213
  CrossrefPubMedGoogle Scholar
• 85 Koschel D, Handzhiev S, Wiedemann B. et al. Acute effects of NPPV in interstitial lung disease with chronic hypercapnic respiratory failure. Respir Med 2010; 104: 291-295
  CrossrefPubMedGoogle Scholar
• 86 Guler SA, Am Hur S, Stickland MK. et al. Survival after inpatient or outpatient pulmonary rehabilitation in patients with fibrotic interstitial lung disease: a multicentre retrospective cohort study. Thorax 2022; 77: 589-595
  CrossrefPubMedGoogle Scholar
• 87 Schegerer A, Loose R, Heuser LJ. et al. Diagnostic reference levels for diagnostic and interventional X-ray procedures in Germany: update and handling. RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. Stuttgart: Thieme; 2019: 739-751
  Google Scholar
• 88 Nagel H, Hering K, Hieckel H. et al. Protokollempfehlungen der AG DRauE zur Durchführung von Low-Dose-Volumen-HRCT-Untersuchungen der Lunge. Fortschr Röntengstr 2017; 189: 553-575
  Article in Thieme ConnectPubMedGoogle Scholar
• 89 Sodickson A, Baeyens PF, Andriole KP. et al. Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology 2009; 251: 175
  CrossrefPubMedGoogle Scholar
• 90 Brenner DJ, Hall EJ. Computed tomography – an increasing source of radiation exposure. N Engl J Med 2007; 357: 2277-2284
  CrossrefPubMedGoogle Scholar
• 91 Wormanns D, Hamer O. Glossary of terms for thoracic imaging – German version of the Fleischner Society recommendations. Rofo 2015; 187: 638-661
  PubMedGoogle Scholar
• 92 Meyer KC, Raghu G, Baughman RP. et al. An official American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med 2012; 185: 1004-1014
  CrossrefPubMedGoogle Scholar
• 93 Hetzel J, Kreuter M, Kähler CM. et al. Bronchoscopic performance of bronchoalveolar lavage in germany – a call for standardization. Sarcoidosis Vasc Diffuse Lung Dis 2021; 38: e2021003
  PubMedGoogle Scholar
• 94 Haslam PL, Baughman RP. Report of ERS Task Force: guidelines for measurement of acellular components and standardization of BAL. Eur Respir J 1999; 14: 245-248
  CrossrefPubMedGoogle Scholar
• 95 Costabel U. Deutsche Gesellschaft für Pneumologie: Empfehlungen zur diagnostischen bronchoalveolaren lavage. Pneumologie 1993; 47: 607-619
  PubMedGoogle Scholar
• 96 Costabel U, Guzman J, Bonella F. et al. Bronchoalveolar lavage in other interstitial lung diseases. Semin Respir Crit Care Med 2007; 28: 514-524
  Article in Thieme ConnectPubMedGoogle Scholar
• 97 Bonella F, Ohshimo S, Bauer P. et al. Bronchoalveolar lavage. Eur Respir Mon 2010; 48: 59-72
  PubMedGoogle Scholar
• 98 Costabel U, Bross K, Rühle K. et al. Ia-like antigens on T-cells and their subpopulations in pulmonary sarcoidosis and in hypersensitivity pneumonitis: analysis of bronchoalveolar and blood lymphocytes. Am Rev Respir Dis 1985; 131: 337-342
  PubMedGoogle Scholar
• 99 Barrera L, Mendoza F, Zuñiga J. et al. Functional diversity of T-cell subpopulations in subacute and chronic hypersensitivity pneumonitis. Am J Respir Crit Care Med 2008; 177: 44-55
  CrossrefPubMedGoogle Scholar
• 100 Behr J, Günther A, Costabel U. S2K-Leitlinie zur Diagnostik der idiopathischen Lungenfibrose [German Guideline for Idiopathic Pulmonary Fibrosis]. Pneumologie 2020; 74: 263-293
  Article in Thieme ConnectPubMedGoogle Scholar
• 101 Adderley N, Humphreys CJ, Barnes H. et al. Bronchoalveolar lavage fluid lymphocytosis in chronic hypersensitivity pneumonitis: a systematic review and meta-analysis. Eur Respir J 2020; 56: 2000206
  CrossrefPubMedGoogle Scholar
• 102 Bonella F, Costabel U. The perpetual enigma of bronchoalveolar lavage fluid lymphocytosis in chronic hypersensitivity pneumonitis: is it of diagnostic value?. Eur Respir J 2020; 56: 2001534
  CrossrefPubMedGoogle Scholar
• 103 Tzilas V, Tzouvelekis A, Bouros E. et al. Diagnostic value of BAL lymphocytosis in patients with indeterminate for usual interstitial pneumonia imaging pattern. Eur Respir J 2019; 54: 1901144
  CrossrefPubMedGoogle Scholar
• 104 Ryu YJ, Chung MP, Han J. et al. Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias. Respir Med 2007; 101: 655-660
  CrossrefPubMedGoogle Scholar
• 105 De Sadeleer LJ, Hermans F, De Dycker E. et al. Impact of BAL lymphocytosis and presence of honeycombing on corticosteroid treatment effect in fibrotic hypersensitivity pneumonitis: a retrospective cohort study. Eur Respir J 2020; 55: 1901983
  CrossrefPubMedGoogle Scholar
• 106 Yamagata A, Arita M, Tachibana H. et al. Impact of bronchoalveolar lavage lymphocytosis on the effects of anti-inflammatory therapy in idiopathic non-specific interstitial pneumonia, idiopathic pleuroparenchymal fibroelastosis, and unclassifiable idiopathic interstitial pneumonia. Respir Res 2021; 22: 115
  CrossrefPubMedGoogle Scholar
• 107 Tomassetti S, Colby TV, Wells AU. et al. Bronchoalveolar lavage and lung biopsy in connective tissue diseases, to do or not to do?. Ther Adv Musculoskelet Dis 2021; 13 DOI: 10.1177/1759720X211059605.
  CrossrefPubMedGoogle Scholar
• 108 Hecker E, Gesierich W. Mediastinales Staging. Allgemein- und Viszeralchirurgie up2date 2021; 15: 513-529
  Article in Thieme ConnectPubMedGoogle Scholar
• 109 Bradley B, Branley H, Egan J. et al. British Thoracic Society Interstitial Lung Disease Guideline Group, British Thoracic Society Standards of Care Committee; Thoracic Society of Australia; New Zealand Thoracic Society; Irish Thoracic Society. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax 2008; 63: v1-v58
  PubMedGoogle Scholar
• 110 Descombes E, Gardiol D, Leuenberger P. Transbronchial lung biopsy: an analysis of 530 cases with reference to the number of samples. Monaldi Arch Chest Dis 1997; 52: 324-329
  PubMedGoogle Scholar
• 111 Curley FJ, Johal JS, Burke ME. et al. Transbronchial lung biopsy: can specimen quality be predicted at the time of biopsy?. Chest 1998; 113: 1037-1041
  CrossrefPubMedGoogle Scholar
• 112 de Boer S, Milne DG, Zeng I. et al. Does CT scanning predict the likelihood of a positive transbronchial biopsy in sarcoidosis?. Thorax 2009; 64: 436-439
  CrossrefPubMedGoogle Scholar
• 113 Halme M, Piilonen A, Taskinen E. Comparison of endobronchial and transbronchial biopsies with high‐resolution CT (HRCT) in the diagnosis of sarcoidosis Note. Apmis 2001; 109: 289-294
  CrossrefPubMedGoogle Scholar
• 114 Sehgal IS, Bal A, Dhooria S. et al. A prospective randomized controlled trial comparing the efficacy and safety of cup vs alligator forceps for performing transbronchial lung biopsy in patients with sarcoidosis. Chest 2016; 149: 1584-1586
  CrossrefPubMedGoogle Scholar
• 115 Jabbardarjani H, Eslaminejad A, Mohammadtaheri Z. et al. The effect of cup versus alligator forceps on the results of transbronchial lung biopsy. J Bronchology Interv Pulmonoly 2010; 17: 117-121
  CrossrefPubMedGoogle Scholar
• 116 Chugh K, Jatwani S. Transbronchial biopsy vs. bronchoalveolar lavage in interstitial lung disease. Curr Opin Pulm Med 2022; 28: 3-8
  CrossrefPubMedGoogle Scholar
• 117 Raghu G, Remy-Jardin M, Richeldi L. et al. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 2022; 205: e18-e47
  CrossrefPubMedGoogle Scholar
• 118 Morell F, Reyes L, Doménech G. et al. Diagnoses and diagnostic procedures in 500 consecutive patients with clinical suspicion of interstitial lung disease. Archivos de Bronconeumología (English Edition) 2008; 44: 185-191
  CrossrefPubMedGoogle Scholar
• 119 Han Q, Luo Q, Chen X. et al. The evaluation of clinical usefulness of transbrochoscopic lung biopsy in undefined interstitial lung diseases: a retrospective study. Clin Respir J 2017; 11: 168-175
  CrossrefPubMedGoogle Scholar
• 120 Sindhwani G, Shirazi N, Sodhi R. et al. Transbronchial lung biopsy in patients with diffuse parenchymal lung disease without ‘idiopathic pulmonary fibrosis pattern’ on HRCT scan-Experience from a tertiary care center of North India. Lung India 2015; 32: 453
  CrossrefPubMedGoogle Scholar
• 121 Sheth JS, Belperio JA, Fishbein MC. et al. Utility of transbronchial vs surgical lung biopsy in the diagnosis of suspected fibrotic interstitial lung disease. Chest 2017; 151: 389-399
  CrossrefPubMedGoogle Scholar
• 122 Pourabdollah M, Shamaei M, Karimi S. et al. Transbronchial lung biopsy: the pathologistʼs point of view. Clin Respir J 2016; 10: 211-216
  CrossrefPubMedGoogle Scholar
• 123 Ramaswamy A, Homer R, Killam J. et al. Comparison of transbronchial and cryobiopsies in evaluation of diffuse parenchymal lung disease. J Bronchology Interv Pulmonol 2016; 23: 14-21
  CrossrefPubMedGoogle Scholar
• 124 Wahidi MM, Argento AC, Mahmood K. et al. Comparison of Forceps, Cryoprobe, and Thoracoscopic Lung Biopsy for the Diagnosis of Interstitial Lung Disease – The CHILL Study. Respiration 2022; 101: 394-400
  CrossrefPubMedGoogle Scholar
• 125 Raghu G, Remy-Jardin M, Myers JL. et al. Diagnosis of idiopathic pulmonary fibrosis. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 2018; 198: e44-e68
  PubMedGoogle Scholar
• 126 Chami HA, Diaz-Mendoza J, Chua A. et al. Transbronchial biopsy and cryobiopsy in the diagnosis of hypersensitivity pneumonitis among patients with interstitial lung disease. Ann Am Thorac Soc 2021; 18: 148-161
  CrossrefPubMedGoogle Scholar
• 127 Adams TN, Newton CA, Batra K. et al. Utility of bronchoalveolar lavage and transbronchial biopsy in patients with hypersensitivity pneumonitis. Lung 2018; 196: 617-622
  CrossrefPubMedGoogle Scholar
• 128 Pérez ERF, Travis WD, Lynch DA. et al. Diagnosis and evaluation of hypersensitivity pneumonitis: CHEST guideline and expert panel report. Chest 2021; 160: e97-e156
  CrossrefPubMedGoogle Scholar
• 129 Crouser E, Maier L, Wilson K. et al. on behalf of the American Thoracic Society. Assembly on Clinical Problems. Diagnosis and Detection of Sarcoidosis. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2020; 201: e26
  CrossrefPubMedGoogle Scholar
• 130 Häntschel M, Eberhardt R, Petermann C. et al. Diagnostic Yield of Transbronchial Lung Cryobiopsy Compared to Transbronchial Forceps Biopsy in Patients with Sarcoidosis in a Prospective, Randomized, Multicentre Cross-Over Trial. J Clin Med 2021; 10: 5686
  CrossrefPubMedGoogle Scholar
• 131 Gupta N, Finlay GA, Kotloff RM. et al. Lymphangioleiomyomatosis diagnosis and management: high-resolution chest computed tomography, transbronchial lung biopsy, and pleural disease management. An Official American Thoracic Society/Japanese Respiratory Society Clinical Practice Guideline. Am J Respir Crit Care Med 2017; 196: 1337-1348
  CrossrefPubMedGoogle Scholar
• 132 Ye L, Jin M, Bai C. Clinical analysis of patients with pulmonary lymphangioleiomyomatosis (PLAM) in mainland China. Respir Med 2010; 104: 1521-1526
  CrossrefPubMedGoogle Scholar
• 133 Meraj R, Wikenheiser-Brokamp KA, Young LR. et al. Utility of transbronchial biopsy in the diagnosis of lymphangioleiomyomatosis. Front Med 2012; 6: 395-405
  CrossrefPubMedGoogle Scholar
• 134 Rittirak W, Sompradeekul S. Diagnostic yield of fluoroscopy-guided transbronchial lung biopsy in non-endobronchial lung lesion. J Med Assoc Thai 2007; 90: 68-73
  PubMedGoogle Scholar
• 135 Ost DE, Ernst A, Lei X. et al. Diagnostic yield and complications of bronchoscopy for peripheral lung lesions. Results of the AQuIRE registry. Am J Respir Crit Care Med 2016; 193: 68-77
  CrossrefPubMedGoogle Scholar
• 136 Trapnell BC, Nakata K, Bonella F. et al. Pulmonary alveolar proteinosis. Nature Reviews Disease Primers 2019; 5: 1-17
  CrossrefPubMedGoogle Scholar
• 137 Azuma K, Takimoto T, Kasai T. et al. Diagnostic yield and safety of bronchofiberscopy for pulmonary alveolar proteinosis. Respiratory Investigation 2021; 59: 757-765
  CrossrefPubMedGoogle Scholar
• 138 Babiak A, Hetzel J, Krishna G. et al. Transbronchial cryobiopsy: a new tool for lung biopsies. Respiration 2009; 78: 203-208
  CrossrefPubMedGoogle Scholar
• 139 Behr J, Günther A, Bonella F. et al. S2K guideline for diagnosis of idiopathic pulmonary fibrosis. Respiration 2021; 100: 238-271
  CrossrefPubMedGoogle Scholar
• 140 Kheir F, Uribe Becerra JP, Bissell B. et al. Transbronchial lung cryobiopsy in patients with interstitial lung disease: a systematic review. Ann Am Thorac Soc 2022; 19: 1193-1202
  CrossrefPubMedGoogle Scholar
• 141 Hetzel J, Maldonado F, Ravaglia C. et al. Transbronchial cryobiopsies for the diagnosis of diffuse parenchymal lung diseases: expert statement from the cryobiopsy working group on safety and utility and a call for standardization of the procedure. Respiration 2018; 95: 188-200
  CrossrefPubMedGoogle Scholar
• 142 Maldonado F, Danoff SK, Wells AU. et al. Transbronchial cryobiopsy for the diagnosis of interstitial lung diseases: CHEST guideline and expert panel report. Chest 2020; 157: 1030-1042
  CrossrefPubMedGoogle Scholar
• 143 Raghu G, Collard HR, Egan JJ. et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011; 183: 788-824 DOI: 10.1164/rccm.2009-040GL.
  CrossrefPubMedGoogle Scholar
• 144 Raghu G, Remy-Jardin M, Myers JL. et al. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2018; 198: e44-e68 DOI: 10.1164/rccm.201807-1255ST.
  CrossrefPubMedGoogle Scholar
• 145 Gaensler EA, Carrington CB. Open biopsy for chronic diffuse infiltrative lung disease: clinical, roentgenographic, and physiological correlations in 502 patients. Ann Thorac Surg 1980; 30: 411-426 DOI: 10.1016/s0003-4975(10)61291-x.
  CrossrefPubMedGoogle Scholar
• 146 Burt ME, Flye MW, Webber BL. et al. Prospective evaluation of aspiration needle, cutting needle, transbronchial, and open lung biopsy in patients with pulmonary infiltrates. Ann Thorac Surg 1981; 32: 146-153 DOI: 10.1016/s0003-4975(10)61021-1.
  CrossrefPubMedGoogle Scholar
• 147 Miller RR, Nelems B, Muller NL. et al. Lingular and right middle lobe biopsy in the assessment of diffuse lung disease. Ann Thorac Surg 1987; 44: 269-273 DOI: 10.1016/s0003-4975(10)62071-1.
  CrossrefPubMedGoogle Scholar
• 148 Krasna MJ, White CS, Aisner SC. et al. The role of thoracoscopy in the diagnosis of interstitial lung disease. Ann Thorac Surg 1995; 59: 348-351 DOI: 10.1016/0003-4975(94)00844-w.
  CrossrefPubMedGoogle Scholar
• 149 Miller JD, Urschel JD, Cox G. et al. A randomized, controlled trial comparing thoracoscopy and limited thoracotomy for lung biopsy in interstitial lung disease. Ann Thorac Surg 2000; 70: 1647-1650 DOI: 10.1016/s0003-4975(00)01913-5.
  CrossrefPubMedGoogle Scholar
• 150 Flint A, Martinez FJ, Young ML. et al. Influence of sample number and biopsy site on the histologic diagnosis of diffuse lung disease. Ann Thorac Surg 1995; 60: 1605-1607 discussion 1607–1608 DOI: 10.1016/0003-4975(95)00895-0.
  CrossrefPubMedGoogle Scholar
• 151 Fibla JJ, Brunelli A, Allen MS. et al. Do the number and volume of surgical lung biopsies influence the diagnostic yield in interstitial lung disease? A propensity score analysis. Archivos de Bronconeumología (English Edition) 2015; 51: 76-79
  CrossrefPubMedGoogle Scholar
• 152 Khalil M, Cowen M, Chaudhry M. et al. Single versus multiple lung biopsies for suspected interstitial lung disease. Asian Cardiovasc Thorac Ann 2016; 24: 788-791
  CrossrefPubMedGoogle Scholar
• 153 Monaghan H, Wells AU, Colby TV. et al. Prognostic implications of histologic patterns in multiple surgical lung biopsies from patients with idiopathic interstitial pneumonias. Chest 2004; 125: 522-526
  CrossrefPubMedGoogle Scholar
• 154 Flaherty KR, Travis WD, Colby TV. et al. Histopathologic variability in usual and nonspecific interstitial pneumonias. Am J Respir Crit Care Med 2001; 164: 1722-1727
  CrossrefPubMedGoogle Scholar
• 155 Bradley B, Branley HM, Egan JJ. et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax 2008; 63 (Suppl. 05) v1-v58 DOI: 10.1136/thx.2008.101691.
  CrossrefPubMedGoogle Scholar
• 156 Raghu G, Remy-Jardin M, Myers J. et al. American Thoracic Society. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2018; 198: e44--e68
  CrossrefPubMedGoogle Scholar
• 157 Hutchinson JP, McKeever TM, Fogarty AW. et al. Surgical lung biopsy for the diagnosis of interstitial lung disease in England: 1997–2008. Eur Respir J 2016; 48: 1453-1461 DOI: 10.1183/13993003.00378-2016.
  CrossrefPubMedGoogle Scholar
• 158 Kayatta MO, Ahmed S, Hammel JA. et al. Surgical biopsy of suspected interstitial lung disease is superior to radiographic diagnosis. Ann Thorac Surg 2013; 96: 399-401
  CrossrefPubMedGoogle Scholar
• 159 Tacconi F, Pompeo E. Non-intubated video-assisted thoracic surgery: where does evidence stand?. J Thorac Dis 2016; 8: S364-S375
  CrossrefPubMedGoogle Scholar
• 160 Lohser J, Slinger P. Lung injury after one-lung ventilation: a review of the pathophysiologic mechanisms affecting the ventilated and the collapsed lung. Anesthesia & Analgesia 2015; 121: 302-318
  CrossrefPubMedGoogle Scholar
• 161 Pompeo E, Sorge R, Akopov A. et al. Non-intubated thoracic surgery – a survey from the European Society of Thoracic Surgeons. Ann Transl Med 2015; 3: 37
  PubMedGoogle Scholar
• 162 Galetin T, Lopez-Pastorini A, Kosse N. et al. Video-assisted Thoracoscopic Surgery in Local Anaesthesia and Analgosedation – a Survey of the Members of the German Society of Thoracic Surgeons. Zentralbl Chir 2019; 145: 278-283
  PubMedGoogle Scholar
• 163 Pompeo E, Rogliani P, Cristino B. et al. Awake thoracoscopic biopsy of interstitial lung disease. Ann Thorac Surg 2013; 95: 445-452
  CrossrefPubMedGoogle Scholar
• 164 Kurihara C, Tolly B, DeWolf A. et al. Thoracoscopic lung biopsy under regional anesthesia for interstitial lung disease. Reg Anesth Pain Med 2020; 45: 255-259
  CrossrefPubMedGoogle Scholar
• 165 Peng G, Liu M, Luo Q. et al. Spontaneous ventilation anesthesia combined with uniportal and tubeless thoracoscopic lung biopsy in selected patients with interstitial lung diseases. J Thorac Dis 2017; 9: 4494-4501
  CrossrefPubMedGoogle Scholar
• 166 Kim TH, Cho JH. Nonintubated Video-Assisted Thoracoscopic Surgery Lung Biopsy for Interstitial Lung Disease. Thorac Surg Clin 2020; 30: 41-48
  CrossrefPubMedGoogle Scholar
• 167 Bedetti B, Patrini D, Bertolaccini L. et al. Uniportal non-intubated thoracic surgery. J Vis Surg 2018; 4: 18
  CrossrefPubMedGoogle Scholar
• 168 Gonzalez-Rivas D, Bonome C, Fieira E. et al. Non-intubated video-assisted thoracoscopic lung resections: the future of thoracic surgery?. Eur J Cardiothorac Surg 2016; 49: 721-731
  CrossrefPubMedGoogle Scholar
• 169 Cherchi R, Grimaldi G, Pinna-Susnik M. et al. Retrospective outcomes analysis of 99 consecutive uniportal awake lung biopsies: a real standard of care?. Journal of Thoracic Disease 2020; 12: 4717
  CrossrefPubMedGoogle Scholar
• 170 Jeon C-S, Yoon DW, Moon SM. et al. Non-intubated video-assisted thoracoscopic lung biopsy for interstitial lung disease: a single-center experience. J Thorac Dis 2018; 10: 3262
  CrossrefPubMedGoogle Scholar
• 171 Kiss G, Castillo M. Nonintubated anesthesia in thoracic surgery: general issues. Ann Transl Med 2015; 3: 110
  PubMedGoogle Scholar
• 172 Han D, Cao Y, Wu H. et al. Uniportal video-assisted thoracic surgery for the treatment of lung cancer: a consensus report from Chinese Society for Thoracic and Cardiovascular Surgery (CSTCVS) and Chinese Association of Thoracic Surgeons (CATS). Transl Lung Cancer Res h 2020; 9: 971-987
  CrossrefPubMedGoogle Scholar
• 173 Travis WD, Costabel U, Hansell DM. et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2013; 188: 733-748
  CrossrefPubMedGoogle Scholar
• 174 Länger F, Stark H, Braubach P. et al. Schädigungsmuster interstitieller Lungenerkrankungen. Der Pathologe 2018; 39: 262-271
  CrossrefPubMedGoogle Scholar
• 175 Länger F, Stark H, Braubach P. et al. Injury patterns in interstitial lung diseases. Der Pathologe 2018; 39: 262-271
  CrossrefPubMedGoogle Scholar
• 176 Behr J, Günther A, Bonella F. et al. S2K-Leitlinie zur Diagnostik der idiopathischen Lungenfibrose. Pneumologie 2020; 74: 263-293
  Article in Thieme ConnectPubMedGoogle Scholar
• 177 Furini F, Carnevale A, Casoni GL. et al. The role of the multidisciplinary evaluation of interstitial lung diseases: systematic literature review of the current evidence and future perspectives. Front Med (Lausanne) 2019; 6: 246
  CrossrefPubMedGoogle Scholar
• 178 Flaherty KR, King Jr TE, Raghu G. et al. Idiopathic interstitial pneumonia: what is the effect of a multidisciplinary approach to diagnosis?. Am J Respir Crit Care Med 2004; 170: 904-910
  CrossrefPubMedGoogle Scholar
• 179 Flaherty KR, Andrei A-C, King Jr TE. et al. Idiopathic interstitial pneumonia: do community and academic physicians agree on diagnosis?. Am J Respir Crit Care Med 2007; 175: 1054-1060
  CrossrefPubMedGoogle Scholar
• 180 Jo HE, Glaspole IN, Levin KC. et al. Clinical impact of the interstitial lung disease multidisciplinary service. Respirology 2016; 21: 1438-1444
  CrossrefPubMedGoogle Scholar
• 181 Chaudhuri N, Spencer L, Greaves M. et al. A review of the multidisciplinary diagnosis of interstitial lung diseases: a retrospective analysis in a single UK specialist centre. J Clin Med 2016; 5: 66
  CrossrefPubMedGoogle Scholar
• 182 Biglia C, Ghaye B, Reychler G. et al. Multidisciplinary management of interstitial lung diseases: a real-life study. Sarcoidosis Vasc Diffuse Lung Dis 2019; 36: 108-115
  PubMedGoogle Scholar
• 183 Walsh SL, Wells AU, Desai SR. et al. Multicentre evaluation of multidisciplinary team meeting agreement on diagnosis in diffuse parenchymal lung disease: a case-cohort study. Lancet Respir Med 2016; 4: 557-565
  CrossrefPubMedGoogle Scholar
• 184 Valeyre D. Towards a better diagnosis of idiopathic pulmonary fibrosis. Eur Respir Rev 2011; 20: 108-113 DOI: 10.1183/09059180.00001611.
  CrossrefPubMedGoogle Scholar
• 185 Spagnolo P, Tonelli R, Cocconcelli E. et al. Idiopathic pulmonary fibrosis: diagnostic pitfalls and therapeutic challenges. Multidiscip Respir Med 2012; 7: 42 DOI: 10.1186/2049-6958-7-42.
  CrossrefPubMedGoogle Scholar
• 186 Nathan SD, Shlobin OA, Weir N. et al. Long-term course and prognosis of idiopathic pulmonary fibrosis in the new millennium. Chest 2011; 140: 221-229 DOI: 10.1378/chest.10-2572.
  CrossrefPubMedGoogle Scholar
• 187 Valeyre D. Towards a better diagnosis of idiopathic pulmonary fibrosis. Eur Respir Rev 2011; 20: 108-113
  CrossrefPubMedGoogle Scholar
• 188 Flaherty KR, Travis WD, Colby TV. et al. Histopathologic variability in usual and nonspecific interstitial pneumonias. Am J Respir Crit Care Med 2001; 164: 1722-1727 DOI: 10.1164/ajrccm.164.9.2103074.
  CrossrefPubMedGoogle Scholar
• 189 Nicholson A, Addis B, Bharucha H. et al. Inter-observer variation between pathologists in diffuse parenchymal lung disease. Thorax 2004; 59: 500-505
  CrossrefPubMedGoogle Scholar
• 190 Raghu G, Flaherty KR, Lederer DJ. et al. Use of a molecular classifier to identify usual interstitial pneumonia in conventional transbronchial lung biopsy samples: a prospective validation study. Lancet Respir Med 2019; 7: 487-496
  CrossrefPubMedGoogle Scholar
• 191 Morell F, Villar A, Montero MA. et al. Chronic hypersensitivity pneumonitis in patients diagnosed with idiopathic pulmonary fibrosis: a prospective case-cohort study. Lancet Respir Med 2013; 1: 685-694 DOI: 10.1016/S2213-2600(13)70191-7.
  CrossrefPubMedGoogle Scholar
• 192 Park JH, Kim DS, Park IN. et al. Prognosis of fibrotic interstitial pneumonia: idiopathic versus collagen vascular disease-related subtypes. Am J Respir Crit Care Med 2007; 175: 705-711 DOI: 10.1164/rccm.200607-912OC.
  CrossrefPubMedGoogle Scholar
• 193 Strange C, Highland KB. Interstitial lung disease in the patient who has connective tissue disease. Clin Chest Med 2004; 25: 549-559
  CrossrefPubMedGoogle Scholar
• 194 Tan E, Feltkamp T, Smolen J. et al. Range of antinuclear antibodies in “healthy” individuals. Arthritis Rheum 1997; 40: 1601-1611
  CrossrefPubMedGoogle Scholar
• 195 Solomon DH, Kavanaugh AJ, Schur PH. et al. Evidence‐based guidelines for the use of immunologic tests: antinuclear antibody testing. Arthritis Rheum 2002; 47: 434-444
  CrossrefPubMedGoogle Scholar
• 196 Salisbury ML, Myers JL, Belloli EA. et al. Diagnosis and Treatment of Fibrotic Hypersensitivity Pneumonia. Where We Stand and Where We Need to Go. Am J Respir Crit Care Med 2017; 196: 690-699 DOI: 10.1164/rccm.201608-1675PP.
  CrossrefPubMedGoogle Scholar
• 197 Sennekamp J, Müller-Wening D, Amthor M. et al. Guidelines for diagnosing extrinsic allergic alveolitis (hypersensitivity pneumonitis)(German Extrinsic Allergic Alveolitis Study Group). Pneumologie 2007; 61: 52-56
  Article in Thieme ConnectPubMedGoogle Scholar
• 198 Buendía-Roldán I, Santiago-Ruiz L, Pérez-Rubio G. et al. A major genetic determinant of autoimmune diseases is associated with the presence of autoantibodies in hypersensitivity pneumonitis. Eur Respir J 2020; 56: 1901380
  CrossrefPubMedGoogle Scholar
• 199 Guler SA, Ellison K, Algamdi M. et al. Heterogeneity in unclassifiable interstitial lung disease. A systematic review and meta-analysis. Ann Am Thorac Soc 2018; 15: 854-863
  CrossrefPubMedGoogle Scholar
• 200 Raghu G, Amatto VC, Behr J. et al. Comorbidities in idiopathic pulmonary fibrosis patients: a systematic literature review. Eur Respir J 2015; 46: 1113-1130
  CrossrefPubMedGoogle Scholar

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