scholarly journals Interstitial lung disease: A case report

2013 ◽  
Vol 24 (1) ◽  
pp. 52-54
Author(s):  
SM Kamal ◽  
Md Abu Bakar ◽  
MA Ahad

A 65 years old farmer was admitted in Medicine ward with the complaints of progressive exertional breathlessness, non-productive cough and recurrent episodes of fever. The patient had clubbing and chest examination revealed end inspiratory crackles. Chest x-ray, CT scan of chest and spirometry revealed the features of interstitial lung disease (ILD). So we diagnosed the case as idiopathic pulmonary fibrosis variety of ILD. We reported this rare case for developing awareness among the clinicians. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14118 Medicine TODAY Vol.24(1) 2012 pp.52-54

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1422.3-1423
Author(s):  
T. Hoffmann ◽  
P. Oelzner ◽  
F. Marcus ◽  
M. Förster ◽  
J. Böttcher ◽  
...  

Background:Interstitial lung disease (ILD) in inflammatory rheumatic diseases (IRD) is associated with increased mortality. Moreover, the lung is one of the most effected organs on IRD. Consequently, screening methods were required to the detect ILD in IRD.Objectives:The objective of the following study is to evaluate the diagnostic value of lung function test, chest x-ray and HR-CT of the lung in the detection of ILD at the onset of IRD.Methods:The study is designed as a case-control study and includes 126 patients with a newly diagnosed IRD. It was matched by gender, age and the performance of lung function test and chest x-ray. The sensitivity and specificity were verified by crosstabs and receiver operating characteristic (ROC) curve analysis. The study cohort was divided in two groups (ILD group: n = 63 and control group: n = 63). If possible, all patients received a lung function test and optional a chest x-ray. Patients with pathological findings in the screening tests (chest x-ray or reduced diffusing capacity for carbon monoxide (DLCO) < 80 %) maintained a high-resolution computer tomography (HR-CT) of the lung. Additionally, an immunological bronchioalveolar lavage was performed in the ILD group as gold standard for the detection of ILD.Results:The DLCO (< 80 %) revealed a sensitivity of 83.6 % and specificity of 45.8 % for the detection of ILD. Other examined parameter of lung function test showed no sufficient sensitivity as screening test (FVC = Forced Vital Capacity, FEV1 = Forced Expiratory Volume in 1 second, TLC = Total Lung Capacity, TLCO = Transfer factor of the Lung for carbon monoxide). Also, a combination of different parameter did not increase the sensitivity. The sensitivity and specificity of chest x-ray for the verification of ILD was 64.2 % versus 73.6 %. The combination of DLCO (< 80 %) and chest x-ray showed a sensitivity with 95.2 % and specificity with 38.7 %. The highest sensitivity (95.2 %) and specificity (77.4 %) was observed for the combination of DLCO (< 80 %) and HR-CT of the lung.Conclusion:The study highlighted that a reduced DLCO in lung function test is associated with a lung involvement in IRD. DLCO represented a potential screening parameter for lung manifestation in IRD. Especially patients with suspected vasculitis should receive an additional chest x-ray. Based on the high sensitivity of DLCO in combination with chest x-ray or HR-CT for the detection of ILD in IRD, all patients with a reduced DLCO (< 80%) should obtained an imaging of the lung.Disclosure of Interests:None declared


2018 ◽  
Vol 10 (1) ◽  
pp. 66-71
Author(s):  
Paramita Bhattacharya ◽  
Susmita Ghosh ◽  
Sarbani Sengupta ◽  
Angira Dasgupta ◽  
Kaushik Ghosh ◽  
...  

Background: The burden of interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients in resource limited countries like India is often under-reported. This study was conducted to find out the clinicoradiological profile of ILD in patients with RA in India. Aims and Objectives: (1)To find out the frequency of Interstitial Lung Disease (ILD) in Rheumatoid Arthritis (RA) (2) To correlate the clinical findings with those of radiological(Chest x-ray & HRCT Thorax) and pulmonary function tests including Spirometry, TLCO (Diffusing capacity of the Lung for Carbon monoxide/DLCO Corrected for alveolar volume i.e., DLCO/V) Estimation. Materials and Methods: Thirty consecutive patients of RA (with or without pulmonary symptoms or signs) who fulfill the American Classification of Rheumatology criteria1987 were selected from the patients attending the General Medicine OPD (Rheumatology Division) of B.R. Singh Hospital during the study period regardless of being on any medications for RA. This was a cross-sectional, descriptive study. Results were tabulated in Microsoft office excel worksheet and descriptive statistics were expressed as means, standard deviations (SD) mean for continuous normally distributed data and as percentages. Statistical software SPSS version 19.0 was used for data analysis. Unpaired t test (for continuous data)/Chi square test (for proportion) was used for comparing cases and controls. Results: The frequency of ILD in RA was 60%. Female patients with a positive rheumatoid factor had a greater chance of development of ILD.The frequency was found to be increased after the age of 40 years. Though in this study 60% of patients had restrictive pattern, 31% had obstructive and 3 % had mixed pattern on Spirometry. The patients with deforming RA had greater frequency of restrictive or mixed pattern on Spirometry. 22.22% patients had a decreased TLCO despite having normal CXR. Despite being asymptomatic12 patients had restrictive lung disease and reduced TLCO with HRCT evidence of ILD. Overall, Spirometry & TLCO are the most appropriate tests to detect restrictive lung disease in patients with RA. In fact, HRCT can show evidence of ILD even when clinical parameters and Chest X-ray are normal.On HRCT of thorax reticular pattern and sub-pleural fibrosis (UIP-Usual interstitial pneumonia) are the predominant pattern. Conclusion: The frequency of ILD in RA is quite high. It may be recommended to use Spirometry & TLCO as screening test for detection of restrictive lung disease in patients with RA who should undergo HRCT of chest to confirm presence of ILD in a resource limited setting.


Respiration ◽  
2016 ◽  
Vol 93 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Luca Vizioli ◽  
Federica Ciccarese ◽  
Paola Forti ◽  
Anna Maria Chiesa ◽  
Marco Giovagnoli ◽  
...  

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1607.2-1607
Author(s):  
T. Vojinovic ◽  
M. Fredi ◽  
P. Ceruti ◽  
D. Modina ◽  
F. Franceschini ◽  
...  

Background:Idiopathic Inflammatory Myositis (IIM) is a group of heterogeneous connective tissue diseases, primarily characterized by chronic muscle inflammation as well as myositis-specific or myositis-associated autoantibodies and a spectrum of different extra-muscular features.The most frequent organ involment in IIM is Interstitial Lung Disease (ILD), occurring in 5-80% of different IIMs cases and considered the hallmark of morbidity and mortality in patients with IIMs.Objectives:To retrospectively assess the predictive factors for development of ILD in IIM patientsMethods:We retrospectively analyzed the prevalence of ILD in a single-center cohort of 165 IIM patients. Patient data was collected from clinical charts. ILD was diagnosed by chest X-ray scan and chest CT scan. All chest CT and chest X-ray scans available and performed at our hospital were consequently re-evaluated by our expert pneumologist for uniform evaluation.Results:Myositis-related ILD (M-ILD) was found in 52 IIM patients (31.5%): 46.15% was affected by anti-synthetase syndrome (ARS), 21.15% by polymyositis (PM), 19.23% by dermatomyositis (DM) and 13.46% by overlap myositis. The pulmonary involvement was characterized by Non-specific interstitial pneumonia (NSIP) (30.6%), Unusual Interstitial Pneumonia (UIP) (38.77%), Bronchiolitis Obliterans with Organizing Pneumonia (BOOP) (20.4%), overlap NSIP/BOOP (4.1%) and Undetermined/Unspecific pattern (6.12%). Eighty four percent of M-ILD consisted of non-smokers and 69.23% presented with dyspnea at onset.ILD was diagnosed in 90.38% of patients within the first year of IIM diagnosis (early onset ILD) and was associated with dyspnea and/or cough in 70.2% and 17% respectively. On the other hand, late onset ILD presented mostly with dyspnea and/or cough in 60% of cases and was significantly associated with anti-Ku antobodies.At onset ILD was significantly associated with: ARS (p<0.0001; OR:12.98), anti-Jo-1 (p<0.0001; OR:6.1), anti-Ro (p=0.038; OR:2.2), mechanic’s hands (p<0.0001; OR:10.41), arthritis (p=0.01; OR:2.58), polyarthritis (p=0.001; OR:4.578), dyspnea (p<0.0001; OR:9.66), and high levels of CPK (p=0.0001) and GOT (p=0.0146). By contrast, the following features: DM (p=0.012; OR:0.36), facial rash (p=0.003; OR:0.31), anti-NXP-2 (p=0.019; OR<0.0001), anti-PL-12 (p=0,03; OR<0.0001) and myositis (p<0.0001; OR:0.173) present at onset were less frequently associated with M-ILD.At multivariate analysis M-ILD was predicted by anti-Ro (p=0.0448), polyarthritis (p=0.0093) and dyspnea (p=0.0001) at onset. On the other hand, patients presenting myositis (p=0.0383) and facial rash (p=0.0398) at onset were less likely to developed M-ILD.Conclusion:ILD occurs in about one third of patients with IIM, mostly affected by ARS. The presence of anti-Ro antibodies as well as polyarthritis and dyspnea at onset predict the development of ILD.Disclosure of Interests:None declared


Lung India ◽  
2015 ◽  
Vol 32 (6) ◽  
pp. 620 ◽  
Author(s):  
Suhas Aagre ◽  
Apurva Patel ◽  
Pradip Kendre ◽  
Asha Anand

2020 ◽  
Vol 92 (3) ◽  
pp. 84-91
Author(s):  
E. Kh. Anaev

Drug-induced interstitial lung disease (D-ILD) can be caused by various drugs, including antibiotics, amiodarone, antitumor, rheumatological and non-steroidal anti-inflammatory drugs. D-ILD includes hypersensitivity reactions, organizing and non-specific interstitial pneumonia, eosinophilic lung diseases, diffuse alveolar damage and alveolar hypoventilation. To exclude other causes of pulmonary diseases, an assessment of the medical history, physical data and examination results, which may include chest X-ray/multispiral computed tomography (MSCT), lung function tests, and bronchoscopy with bronchoalveolar lavage, are necessary. Diagnosis of D-ILD is difficult due to the heterogeneity of clinical, radiological and histological data. The X-ray pathological phenotype of D-ILD is different; a specific MSCT pattern has not been identified. Treatment includes drug withdrawal and, in some cases, glucocorticoid therapy, although there are no prospective studies on their effect on the outcome of the disease. This article provides various drugs that cause ILD, approaches to their diagnosis and treatment.


2014 ◽  
Vol 4 (1) ◽  
pp. 47-49
Author(s):  
MA Rahim ◽  
S Parvin ◽  
S Zaman ◽  
HF Haque ◽  
MM Rahman ◽  
...  

Lung is the most common extra-articular site of involvement in rheumatoid arthritis (RA). It can involve pleura, lung parenchyma and pulmonary vasculature. Among many diseases, most debilitating one is RA associated interstitial lung disease (RA-ILD). Here, we describe a middle aged Bangladeshi lady who presented because of progressively deteriorating non-productive cough, exertional dyspnea and polyarthritis of 5 month duration. Diagnostic workup confirmed RA-ILD and she responded well with prednisolone, hydroxychloroquine and azathioprine.DOI: http://dx.doi.org/10.3329/birdem.v4i1.18554 Birdem Med J 2014; 4(1): 47-49


2013 ◽  
Vol 72 (Suppl 3) ◽  
pp. A857.1-A857
Author(s):  
I. Al-Shakarchi ◽  
B. Lobão ◽  
C. Henriques ◽  
S. Steer ◽  
P. Gordon ◽  
...  

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