Respiratory · UKMLA & AKT
Connective tissue disease-associated ILD
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise connective tissue disease-associated ild — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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