We thank Dr Medford for his insightful comments regarding our study1 evaluating the characteristics and survival of patients with autoimmune-featured interstitial lung disease (AIF-ILD). These patients had signs or symptoms and serologic test results suggestive of autoimmunity but did not meet the criteria for a defined connective tissue disease. Although survival for all patients with AIF-ILD was comparable to patients with idiopathic pulmonary fibrosis, the subgroup of patients with AIF-ILD and an antinuclear antibody (ANA) titer≥1:1,280 had improved survival. As Dr Medford noted, nonspecific interstitial pneumonia patterns, which are generally associated with improved outcomes,2 were seen more commonly in the subgroup of patients with AIF-ILD and high ANA titers. Nonetheless, the majority of patients with AIF-ILD and high ANA titers had a usual interstitial pneumonia pattern on CT scan and lung biopsy (59% and 73%, respectively), suggesting that radiographic and histopathologic patterns may not fully account for the differences in survival. The small number of patients with AIF-ILD and high ANA titers precluded subgroup analysis to determine the impact of radiographic and histopathologic patterns on survival. Our results underscore the significance of performing a systematic evaluation for autoimmune features in patients with interstitial lung disease regardless of radiographic and pathologic patterns, as patients with usual interstitial pneumonia may meet the criteria for AIF-ILD. More importantly, the presence of elevated ANA titers may have prognostic value.