Would you give a trial of immunosuppression in a patient with previously diagnosed IPF who now comes to you with moderate titer ANA and history of discoid lupus but no other clear systemic features or lab abnormalities suggestive of SLE?

No, I would not automatically RX immunosuppressants in this clinical scenario, which has numerous facets to it that do need to be addressed:

1. The treatment for progressive idiopathic pulmonary fibrosis (IPF) is an antifibrotic, not an immunosuppressant. I ALWAYS manage my SLE-pulmonary patients with ...