What laboratory tests are indicated for Interstitial Lung Disease (ILD)?

From the Guidelines

Laboratory tests for interstitial lung disease (ILD) should include complete blood count, comprehensive metabolic panel, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, rheumatoid factor, anti-cyclic citrullinated peptide antibodies, and anti-neutrophil cytoplasmic antibodies, as recommended by the most recent guidelines 1.

Key Laboratory Tests

• Complete blood count
• Comprehensive metabolic panel
• Erythrocyte sedimentation rate
• C-reactive protein
• Antinuclear antibody
• Rheumatoid factor
• Anti-cyclic citrullinated peptide antibodies
• Anti-neutrophil cytoplasmic antibodies

Additional Specific Tests

• Myositis panel (anti-Jo-1, anti-PL-7, anti-PL-12)
• Anti-Scl-70 and anti-centromere antibodies for scleroderma
• Serum precipitins for hypersensitivity pneumonitis

Pulmonary Function Tests

Pulmonary function tests are essential and typically show restrictive pattern with decreased diffusion capacity, as noted in the guidelines 1.

Arterial Blood Gases

Arterial blood gases may reveal hypoxemia, especially with exertion, which is an important consideration in the diagnosis and management of ILD 1.

Serum Biomarkers

Serum biomarkers like KL-6, SP-A, SP-D, and MMP-7 can help assess disease activity and prognosis, as discussed in the guidelines 1.

Interpretation of Laboratory Findings

Laboratory findings should always be interpreted alongside clinical presentation, imaging studies (particularly high-resolution CT scans), and sometimes lung biopsy results for accurate diagnosis and management of ILD, as recommended by the guidelines 1.

From the Research

Laboratory Tests for Interstitial Lung Disease (ILD)

The following laboratory tests are indicated for ILD:

• Autoantibody testing, including:
  • Anti-nuclear antibodies (ANA) 2
  • Rheumatoid factor (RF) 2
  • Anti-citrullinated cyclic peptide antibody (anti-CCP) 2
  • Extractable nuclear antigen antibodies (ENA) 2
  • Double-stranded DNA antibodies (dsDNA) 2
  • Anti-neutrophil cytoplasmic antibodies (ANCA) 2
  • Myositis antibodies 2
• Other laboratory tests, such as:
  • Complete blood count (CBC) 3
  • Blood chemistry tests 3
  • Urinalysis 3

Imaging Studies for ILD

Imaging studies, including:

• High-resolution computed tomography (HRCT) of the thorax 3

Diagnostic Evaluation for ILD

A diagnostic evaluation for ILD should include:

• A thorough patient history and physical examination 3
• Laboratory testing, including autoantibody testing and other laboratory tests 2, 3
• Imaging studies, including HRCT 3
• Multidisciplinary discussion and evaluation by a team of specialists, including pulmonologists, radiologists, and pathologists 4, 5