Multidisciplinary approach to systemic diseases: benefits for diagnosis and management of complex disorders

Several components of the respiratory system may be involved in multisystem diseases, such as the airways, vessels, parenchyma, pleura and respiratory muscles; in addition to the lungs, many other organs may also be involved. ILD, frequently detected in multisystem diseases, has a significant impact on morbidity and mortality in this heterogeneous group of diseases. In particular, many CTDs involve the lungs either directly or as a treatment complication. Pulmonary involvement, and particularly ILD, may be detected at any point in the natural history of a systemic disease. Therefore, a multidisciplinary approach is crucial in the diagnostic work-up, diagnostic/therapeutic decision making and during follow-up, enabling the input of different experts. This has become the current diagnostic reference standard for ILD and is reported to improve diagnostic confidence and agreement compared with the decisions of individual participants of the multidisciplinary discussion. However, many questions regarding the composition and governance of the multidisciplinary team remain unanswered, requiring further studies to better define the power of this tool with the aim of earlier and better-defined diagnosis, management and follow-up.