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Pulmonology

General Rheumatology   

Questions discussed in this category

How would you treat an asymptomatic patient with a positive Blastomyces antibody, evidence of prior granulomatous lung disease on imaging, and who may require immunosuppression in the future?
1 Answer available
What is your approach to treatment of airway involvement, such as recurrent bronchial stenosis, in relapsing polychondritis?
Are there specific immunosuppressive agents effective for this manifestation?
1 Answer available
What are some important considerations for use of ACE inhibition in scleroderma renal crisis patients who require dialysis?
For example, is captopril dialyzable? 
1 Answer available
Would you use the pneumococcal conjugate-21 vaccine (Capvaxive) instead of the conjugate-20 (Prevnar-20) for routine vaccinations in immunosuppressed patients?
2 Answers available
What is your approach to differentiating RA-ILD from medication toxicity (I.e. from methotrexate)?
1 Answer available
Is it necessary to prescribe a steroid taper after two weeks of high-dose prednisone (60 mg daily)?
4 Answers available
In a patient with low titer +anti-SAE antibody and known ILD, but no other clinical features of dermatomyositis, how would you approach further testing or would you treat the patient as dermatomyositis associated ILD?
1 Answer available
How do you approach a patient on anti-TNF with positive Quantiferon (previously negative) with negative chest x-ray and no symptoms?
7 Answers available
Is there a role for the use of transient elastography (FibroScan) to monitor liver fibrosis in patients on long term methotrexate?
3 Answers available
How would you manage cardiac sarcoid with intolerance/contraindications to methotrexate, azathioprine, and mycophenolate/mycophenolic acid and that has proven refractory to adalimumab and infliximab as determined by PET?
2 Answers available
Is there a risk of hepatitis C activation with rituximab in a patient who has a history of HCV treated with antivirals and who is in sustained viral response?
1 Answer available
What is your approach to counseling patients regarding re-initiation of anti-TNF therapy after completion of treatment for non-disseminated pulmonary histoplasmosis?
Would it be safe to resume and if so, when?
2 Answers available
For how long do you recommend treatment for latent tuberculosis prior to initiation of anti-TNF therapy?
6 Answers available
How do you approach management of adult patients with CVID and sarcoid-like syndrome?
1 Answer available
Does your institution have formal policies or work flows to reduce unnecessary IGRAs ordered for patients on biologics?
1 Answer available
How do you approach biologic initiation in patients with inflammatory arthritis and repeatedly indeterminate Quantiferon?
5 Answers available
What else do you consider in the differential diagnosis for pulmonary-renal syndromes if there is low clinical and serologic evidence of AAV, Goodpasture's or other rheumatologic disease (SLE, RA, APS, Scleroderma)?
2 Answers available
How do you approach management of a patient with idiopathic PAH and +ANA, but no other current symptoms/signs of active rheumatologic disease?
3 Answers available
Is it safe to combine mycophenolate and adalimumab for management of pulmonary sarcoidosis in a patient that could not tolerate methotrexate?
3 Answers available
Do you generally recommend starting nintedanib prior to immunosuppressive therapy in a patient with CTD-ILD?
Do you prefer to start with nintedanib and then add immunosuppressive agents, or give a trial of immunosuppressive medication first, then add nintedan...
4 Answers available
Are there any concerns utilizing apremilast for psoriatic arthritis in patients who are also taking roflumilast for COPD?
1 Answer available
What are your recommendations regarding methotrexate usage in patients with persistent chest CT changes post COVID pneumonia?
Would you have a different opinion based on whether it is a new therapy or an existing and previously well-tolerated therapy for the patient?
2 Answers available


Papers discussed in this category

BMJ Open, 2019 May 05
Is incident rheumatoid arthritis interstitial lung disease associated with methotrexate treatment? Results from a multivariate analysis in the ERAS and ERAN inception cohorts.
Rheumatol Int, 2021 Jan 29
Does methotrexate cause progressive fibrotic interstitial lung disease? A systematic review.
Scientific reports, 2017 Aug 10
Analysis of Factors Influencing Diagnostic Accuracy of T-SPOT.TB for Active Tuberculosis in Clinical Practice.
N. Engl. J. Med., 2019 May 20
Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease.
N Engl J Med, 2019 Sep 29
Nintedanib in Progressive Fibrosing Interstitial Lung Diseases.
Arthritis Care Res (Hoboken), 2016 Jan
2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.
Alimentary pharmacology & therapeutics, 2022 May 20
Review article: latent tuberculosis in patients with inflammatory bowel diseases receiving immunosuppression-risks, screening, diagnosis and management.
Arthritis & rheumatology (Hoboken, N.J.), 2015-05
Clinical utility of random anti-tumor necrosis factor drug-level testing and measurement of antidrug antibodies on the long-term treatment response in rheumatoid arthritis.
International journal of rheumatic diseases, 2014-02
Neurosarcoidosis mimicking multiple sclerosis successfully treated with methotrexate and adalimumab.
Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG, 2014-04-18
Efficacy Results of a 52-week Trial of Adalimumab in the Treatment of Refractory Sarcoidosis.
Clinical nuclear medicine, 2016-05
FDG PET/CT Evidence of Effective Treatment of Cardiac Sarcoidosis With Adalimumab.
J Investig Med High Impact Case Rep, 2021 Jan-Dec
Pituitary Sarcoidosis in a Pediatric Patient Successfully Treated With Adalimumab and Methotrexate.
Clinical therapeutics, 2018 Feb
Methotrexate Dose in Patients With Early Rheumatoid Arthritis Impacts Methotrexate Polyglutamate Pharmacokinetics, Adalimumab Pharmacokinetics, and Efficacy: Pharmacokinetic and Exposure-response Analysis of the CONCERTO Trial.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015-08-01
Histoplasmosis complicating tumor necrosis factor-α blocker therapy: a retrospective analysis of 98 cases.
Current opinion in pulmonary medicine, 2013 Sep
Common variable immunodeficiency-associated granulomatous and interstitial lung disease.
International journal of cardiology. Heart & vasculature, 2021 Apr 29
Non-steroidal treatment of cardiac sarcoidosis: A systematic review.
Lupus, 2014 Jul 30
Serious infections in systemic lupus erythematosus with a focus on pneumococcal infections.
MMWR. Morbidity and mortality weekly report, 2024 Sep 12
Use of 21-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices - United States, 2024.
Journal of the Endocrine Society, 2022 Dec 02
Perioperative Evaluation and Management of Patients on Glucocorticoids.
Diagnostics (Basel, Switzerland), 2021 Apr 20
Glucocorticoid Withdrawal-An Overview on When and How to Diagnose Adrenal Insufficiency in Clinical Practice.
Rheumatology (Oxford),
The reliability of immunoassays to detect autoantibodies in patients with myositis is dependent on autoantibody specificity.
Rheumatology (Oxford, England), 2023 Dec 01
Anti-SAE autoantibody in dermatomyositis: original comparative study and review of the literature.

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