Respiratory · UKMLA & AKT
Connective tissue disease-associated ILD
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Lower zone ILD - most CTDs (RA, SSc, PM/DM, Sjögren's) → NSIP or UIP pattern
- Upper zone ILD - ankylosing spondylitis (apical fibrobullous disease); also TB, silicosis, coal workers' pneumoconiosis, sarcoidosis, HP
- Drug-induced ILD (amiodarone, methotrexate, nitrofurantoin, leflunomide) → lower zone fibrosis - mimics CTD-ILD
Ankylosing spondylitis is the only CTD causing upper-zone fibrosis. All other CTDs cause lower-zone predominant ILD. Amiodarone causes lower-zone fibrosis and is a classic exam trap in patients with both a CTD and a drug that causes ILD.
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