Radiological and histopathological features and treatment response by subtypes of interstitial pneumonia with autoimmune features: A prospective, multicentre cohort study - 13/03/24
, Shusuke Yazawa a, Yasutaka Mochizuka a, Atsuki Fukada a, Yuko Tanaka a, Hyogo Naoi a, Yuya Aono a, c, Yusuke Inoue a, Hideki Yasui a, Masato Karayama a, Yuzo Suzuki a, Hironao Hozumi a, Kazuki Furuhashi a, Mikio Toyoshima d, Masato Kono c, Shiro Imokawa e, Takehisa Sano f, Taisuke Akamatsu g, Naoki Koshimizu h, Koshi Yokomura i, Hiroyuki Matsuda j, Yusuke Kaida k, Masahiro Shirai l, Kazutaka Mori m, Masafumi Masuda m, Tomoyuki Fujisawa a, Naoki Inui a, n, Yutaro Nakamura a, l, Hiroaki Sugiura o, Hiromitsu Sumikawa p, Masashi Kitani q, Kazuhiro Tabata r, Noriyoshi Ogawa s, Takafumi Suda aAbstract |
Background |
Patients with idiopathic interstitial pneumonia (IIP) have a favourable prognosis when they have interstitial pneumonia with autoimmune features (IPAF). However, precise IPAF-related findings from high-resolution computed tomography (HRCT) and lung histopathological specimens and the treatment response have not been fully determined. Therefore, this study was conducted to evaluate the relationship between findings on HRCT or lung histopathological specimens and the progression of interstitial pneumonia in patients with IPAF.
Methods |
This multicentre cohort study prospectively enrolled consecutive patients with IIP. At the diagnosis of IIP, we systematically evaluated 74 features suggestive of connective tissue diseases and followed them up. HRCT, lung specimens, serum antibodies, and the clinical course were also evaluated.
Results |
Among 222 patients with IIP, 26 (11.7%) fulfilled the IPAF criteria. During a median observation period of 36 months, patients with IPAF showed better survival than those without IPAF (p = 0.034). While histopathological findings were not related to IPAF, nonspecific interstitial pneumonia (NSIP) with organizing pneumonia (OP) overlap was the most prevalent HRCT pattern (p < 0.001) and the consolidation opacity was the most common radiological finding in IPAF (p = 0.017). Furthermore, in patients with IPAF, the diagnosis of COP or NSIP with OP overlap was associated with a higher increase in %FVC in 1 year than in those with idiopathic pulmonary fibrosis, NSIP, or unclassifiable IIP (p = 0.002).
Conclusions |
This study shows the presence of consolidation opacity on HRCT and the diagnosis of COP or NSIP with OP overlap are associated with IPAF and its favourable treatment response in patients with IPAF.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We prospectively evaluated 222 patients with IIP, 11.7% of them fulfilled the IPAF criteria. |
• | NSIP with OP overlap was the most prevalent HRCT pattern in patients with IPAF. |
• | Consolidation opacity on HRCT was the most common radiological finding in IPAF. |
• | Patients with acute/subacute onset of IPAF showed a favourable response to therapy. |
• | Patients with IPAF and COP or NSIP with OP overlap showed a favourable response to therapy. |
Keywords : Interstitial pneumonia with autoimmune features, Idiopathic interstitial pneumonia, Nonspecific interstitial pneumonia, Organizing pneumonia, Anti-aminoacyl tRNA synthetase (ARS) antibody
Plan
Vol 224
Article 107577- avril 2024 Retour au numéro
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