Clinical differential diagnosis of usual interstitial pneumonia from nonspecific interstitial pneumonia

2000 ◽  
Vol 48 (6) ◽  
pp. 932 ◽  
Author(s):  
Chang Hyeok An ◽  
Young Min Koh ◽  
Man Pyo Chung ◽  
Gee Young Suh ◽  
Soo Jung Kang ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Nonspecific Interstitial Pneumonia ◽  
Clinical Differential Diagnosis

scholarly journals POS1435 CLINICAL CHARACTERIZATION AND PREDICTIVE FACTORS FOR PROGRESSION IN A COHORT OF ILD PATIENTS WITH FEATURES OF AUTOIMMUNITY: ARE IPAF CRITERIA SUFFICIENT?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1002.1-1002
Author(s):  
F. Bozzao ◽  
P. Tomietto ◽  
E. Baratella ◽  
F. Giudici ◽  
M. Kodric ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Predictive Factors ◽  
Usual Interstitial Pneumonia ◽  
Final Diagnosis ◽  
Classification Criteria ◽  
Radiological Progression ◽  
Nonspecific Interstitial Pneumonia ◽  
The Mean ◽  
Functional Deterioration ◽  
Worse Prognosis

Background:It is unknown whether patients with interstitial lung disease (ILD) and only some features of autoimmunity have a different natural history from those with a defined connective tissue disease (CTD-ILD). The classification criteria for “ILD with autoimmune features” (IPAF) may not be able to characterize all these patients, especially those with a usual interstitial pneumonia (UIP) pattern [1].Objectives:To determine clinical characteristics and predictive factors for progression in a cohort of ILD patients with features of autoimmunity, through the application of classification criteria for IPAF and specific CTD, whenever possible.Methods:We retrospectively selected a cohort of consecutive patients with ILD as onset manifestation and features of autoimmunity (at least 1 autoantibody and/or 1 clinical sign/symptom), evaluated by our multidisciplinary unit from March 2009 to March 2020. All the final diagnoses were revised according to the latest CTD and IPAF criteria. Patients were followed up for 33 (16.5-69.5) months.Results:Of the 101 patients enrolled (67.4±10.9 yrs, F/M ratio 65/36), 53 (52.5%) and 37 (36.6%) respectively satisfied the CTD and IPAF criteria. Eleven patients (10.9%) did not satisfy IPAF criteria because of only 1 item (clinical or serologic) within the IPAF domains and a UIP pattern; we defined this group as “autoimmune” UIP (AI-UIP). All the 8 patients initially classified as undifferentiated CTD had sufficient IPAF criteria. Among the IPAF patients (68.2±10.1 years, F/M ratio 20/17), the most common findings were: Nonspecific interstitial pneumonia pattern (56.8%), antinuclear antibodies positivity (43.2%) and arthritis (24.3%). The combination of a positive morphologic and serologic domain was the most common to reach the diagnosis (48.6%). Some IPAF patients had features not included in IPAF criteria, such as non-anti-synthetase myositis-specific antibodies (21.6%), objective sicca syndrome (13.5%) and anti-myeloperoxidase antibodies (2.7%). Over a median of 17 months, 2 IPAF patients (5.4%) developed a definite UIP pattern, while 4 (10.8%) a specific CTD. Comparing the IPAF, CTD-ILD and AI-UIP groups, no statistically significant differences were found in the mean age, sex distribution, smoking habits and mean duration of the disease. However, IPAF patients had a significantly higher prevalence of arterial hypertension and left-sided heart failure and a lower predominance of UIP pattern as expected (10.8% vs. 32.1% vs. 100%, p<0.01). Although no differences were found at the diagnosis, at 1 year the proportion of IPAF patients with radiological progression of the fibrosis and/or functional deterioration (defined by a decline in FVC of ≥ 10% and/or DLCO of ≥ 15% predicted) was lower to that of CTD-ILD and AI-UIP (17.1% vs. 31.4% vs. 63.6%, p 0.01). Fewer IPAF patients needed oxygen support (8.6% vs. 31.4% vs. 36.4, p 0.02). Considering the overall 101 patients, having an IPAF and a UIP pattern respectively predicted a slower (OR: 0.37, p 0.04) and a faster (OR: 3.56, p 0.01) ILD progression at the multivariate analysis.Conclusion:In our cohort, IPAF criteria were useful to identify a subset of patients with a slower ILD progression and a possible evolution to CTD (10-15% of cases) [2]. These criteria do not characterize all the patients with a UIP pattern and limited features of autoimmunity, which seem to have a worse prognosis, independently from the final diagnosis. Further studies are needed to clarify if the prognosis of AI-UIP is different from that of idiopathic pulmonary fibrosis.References:[1]Graney, et al. Ann Am Thorac Soc 2019;16(5):525-33.[2]Sebastiani, et al. Biomedicines 2021,9,17.Disclosure of Interests:None declared

scholarly journals Expression of HSP47 in Usual Interstitial Pneumonia and Nonspecific Interstitial Pneumonia

2005 ◽  
Vol 6 (1) ◽  
Author(s):  
Tomoyuki Kakugawa ◽  
Hiroshi Mukae ◽  
Tomayoshi Hayashi ◽  
Hiroshi Ishii ◽  
Seiko Nakayama ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Nonspecific Interstitial Pneumonia

scholarly journals Video-Assisted Thoracoscopic Lung Biopsy as a Possible Cause of Acute Interstitial Pneumonia in a Patient with Nonspecific Interstitial Pneumonia

2004 ◽  
Vol 11 (6) ◽  
pp. 437-440 ◽  
Author(s):  
D Jeffrey Moore ◽  
Colm P McParland ◽  
Martin J Bullock ◽  
Yannick Cartier ◽  
Paul Hernandez
Keyword(s):  
Case Report ◽  
Interstitial Pneumonia ◽  
Lung Biopsy ◽  
Diffuse Alveolar Damage ◽  
Usual Interstitial Pneumonia ◽  
High Resolution Computed Tomography ◽  
Present Case Report ◽  
Video Assisted ◽  
Acute Interstitial Pneumonia ◽  
Nonspecific Interstitial Pneumonia

The present case report describes a 44-year-old woman who presented with dyspnea due to diffuse interstitial lung disease. High-resolution computed tomography showed features of usual interstitial pneumonia, but the lung biopsy obtained by video-assisted thoracoscopy was consistent with a histological pattern of nonspecific interstitial pneumonia. Following the procedure, the patient developed progressive respiratory distress and died on postoperative day 13 with a clinical picture of acute interstitial pneumonia. The autopsy showed evidence of diffuse alveolar damage superimposed on the background pattern of nonspecific interstitial pneumonia. The present case report supports the notion that patients with a variety of subtypes of idiopathic interstitial pneumonias may be at risk of exacerbation of their underlying disease following thoracic procedures, including video-assisted thoracoscopic lung biopsy.

scholarly journals High-BAL fluid concentrations of RANTES in nonspecific interstitial pneumonia compared with usual interstitial pneumonia

2004 ◽  
Vol 98 (10) ◽  
pp. 945-951 ◽  
Author(s):  
Sumako Yoshioka ◽  
Hiroshi Mukae ◽  
Kanako Sugiyama ◽  
Tomoyuki Kakugawa ◽  
Noriho Sakamoto ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Nonspecific Interstitial Pneumonia

DIFFERENTIAL DIAGNOSTICS OF NON-SPECIFIC INTERSTITIAL PNEUMONIA

2020 ◽  
Vol 2 (1) ◽  
pp. 50-52
Author(s):  
Nargiza Makhmatmuradova ◽  
◽  
Olga Ibadova ◽  
Parvina Zikriyaeva
Keyword(s):  
Differential Diagnosis ◽  
Interstitial Pneumonia ◽  
Lung Diseases ◽  
Clinical Presentation ◽  
Differential Diagnostics ◽  
Hospital Treatment ◽  
Case Histories ◽  
Allergic Alveolitis ◽  
Nonspecific Interstitial Pneumonia ◽  
Exogenous Allergic Alveolitis

A retrospective analysis of case histories of 82 patients with nonspecific interstitial pneumonia, 24 patients with idiopathic pulmonary fibrosis, 8 with exogenous allergic alveolitis, 12 with systemic scleroderma and 6 with drug pneumonia was carried out in hospital treatment in the pulmonology department of the Samarkand city medical hospital in 2010-2019 years. It has been established that in the differential diagnosis of nonspecific interstitial pneumonia and other lung diseases, particular attention should be paid to the anamnesis, clinical presentation and CT signs

Sign in / Sign up

Export Citation Format

Share Document