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Comparison of clinical courses and mortality of connective tissue disease-associated interstitial pneumonias and chronic fibrosing idiopathic interstitial pneumonias.
Kaohsiung J Med Sci. 2019 Jun; 35(6):365-372.KJ

Abstract

Interstitial lung disease (ILD) is a common pulmonary manifestation of connective tissue diseases (CTD). Prognostic effect of radiological usual interstitial pneumonia (UIP) pattern in CTD-associated interstitial lung disease (CTD-ILD) is unknown. This study aimed to investigate the disease progression and mortality of patients with CTD-ILD and idiopathic interstitial pneumonias (IIP) including idiopathic pulmonary fibrosis (IPF) and idiopathic nonspecific interstitial pneumonia and the prognostic impact of the radiological UIP pattern on both disease groups. The medical records of 91 patients (55 with CTD-ILD and 36 with IIP) diagnosed with ILD at pulmonary medicine department, Faculty of Medicine, Gazi University from 2004 to 2014 were retrospectively reviewed. Patients included whose baseline high-resolution computed tomography (HRCT) scans showed either a UIP or non-UIP pattern. While 67.3% (n = 37) of CTD-ILD patients possessed UIP pattern, 38.9% (n = 14) of IIP patients had UIP pattern in HRCT. Respiratory functions including the forced expiratory volume in the first second (FEV1), functional vital capacity (FVC), and transfer coefficient for carbon monoxide (diffusing capacity of the lung for carbon monoxide [DLCO]) of IIP group at the time of diagnosis were significantly lower than CTD-ILD group (P = .007, P = .002, and P = .019, respectively). There was no significant survival difference between CTD-ILD and IIP by using the log-rank test (P = .76). Multivariate analysis revealed that UIP pattern in HRCT (Hazard ratio: 1.85; 95% Confidence interval = 1.14-3; P = .013), annual FVC (Hazard ratio: 0.521; 95% Confidence interval = 0.32-0.84; P = .007), and annual DLCO declines (Hazard ratio: 0.943; 95% Confidence interval = 0.897-0.991; P = .02) were independent risk factors for mortality in both CTD-ILD and IIP groups. We found that UIP pattern in HRCT and annual losses in respiratory functions were the main determinants of prognosis of ILDs either idiopathic or CTD-associated.

Authors+Show Affiliations

Department of Intensive Care, Clinic of Pulmonary Medicine, Dışkapı Yıldırım Beyazıt Research and Education Hospital, Ankara, Turkey.Department of Pulmonary Medicine, Subdivision of Allergy and Immunology, Erciyes University School of Medicine, Kayseri, Turkey.Department of Rheumatology, Clinic of Internal Medicine, Ankara Research and Training Hospital, Ankara, Turkey.Department of Radiology, Gazi University School of Medicine, Ankara, Turkey.Department of Chest Diseases, Gazi University School of Medicine, Ankara, Turkey.Department of Rheumatology, Gazi University School of Medicine, Ankara, Turkey.Department of Chest Diseases, Gazi University School of Medicine, Ankara, Turkey.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30913371

Citation

Yıldırım, Fatma, et al. "Comparison of Clinical Courses and Mortality of Connective Tissue Disease-associated Interstitial Pneumonias and Chronic Fibrosing Idiopathic Interstitial Pneumonias." The Kaohsiung Journal of Medical Sciences, vol. 35, no. 6, 2019, pp. 365-372.
Yıldırım F, Türk M, Bitik B, et al. Comparison of clinical courses and mortality of connective tissue disease-associated interstitial pneumonias and chronic fibrosing idiopathic interstitial pneumonias. Kaohsiung J Med Sci. 2019;35(6):365-372.
Yıldırım, F., Türk, M., Bitik, B., Erbaş, G., Köktürk, N., Haznedaroğlu, Ş., & Türktaş, H. (2019). Comparison of clinical courses and mortality of connective tissue disease-associated interstitial pneumonias and chronic fibrosing idiopathic interstitial pneumonias. The Kaohsiung Journal of Medical Sciences, 35(6), 365-372. https://doi.org/10.1002/kjm2.12066
Yıldırım F, et al. Comparison of Clinical Courses and Mortality of Connective Tissue Disease-associated Interstitial Pneumonias and Chronic Fibrosing Idiopathic Interstitial Pneumonias. Kaohsiung J Med Sci. 2019;35(6):365-372. PubMed PMID: 30913371.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of clinical courses and mortality of connective tissue disease-associated interstitial pneumonias and chronic fibrosing idiopathic interstitial pneumonias. AU - Yıldırım,Fatma, AU - Türk,Murat, AU - Bitik,Berivan, AU - Erbaş,Gonca, AU - Köktürk,Nurdan, AU - Haznedaroğlu,Şeminur, AU - Türktaş,Haluk, Y1 - 2019/03/26/ PY - 2018/09/07/received PY - 2019/03/18/accepted PY - 2019/3/27/pubmed PY - 2020/2/7/medline PY - 2019/3/27/entrez KW - connective tissue disease-associated interstitial lung disease KW - high-resolution computed tomography KW - idiopathic interstitial pneumonia KW - prognosis KW - usual interstitial pneumonia SP - 365 EP - 372 JF - The Kaohsiung journal of medical sciences JO - Kaohsiung J. Med. Sci. VL - 35 IS - 6 N2 - Interstitial lung disease (ILD) is a common pulmonary manifestation of connective tissue diseases (CTD). Prognostic effect of radiological usual interstitial pneumonia (UIP) pattern in CTD-associated interstitial lung disease (CTD-ILD) is unknown. This study aimed to investigate the disease progression and mortality of patients with CTD-ILD and idiopathic interstitial pneumonias (IIP) including idiopathic pulmonary fibrosis (IPF) and idiopathic nonspecific interstitial pneumonia and the prognostic impact of the radiological UIP pattern on both disease groups. The medical records of 91 patients (55 with CTD-ILD and 36 with IIP) diagnosed with ILD at pulmonary medicine department, Faculty of Medicine, Gazi University from 2004 to 2014 were retrospectively reviewed. Patients included whose baseline high-resolution computed tomography (HRCT) scans showed either a UIP or non-UIP pattern. While 67.3% (n = 37) of CTD-ILD patients possessed UIP pattern, 38.9% (n = 14) of IIP patients had UIP pattern in HRCT. Respiratory functions including the forced expiratory volume in the first second (FEV1), functional vital capacity (FVC), and transfer coefficient for carbon monoxide (diffusing capacity of the lung for carbon monoxide [DLCO]) of IIP group at the time of diagnosis were significantly lower than CTD-ILD group (P = .007, P = .002, and P = .019, respectively). There was no significant survival difference between CTD-ILD and IIP by using the log-rank test (P = .76). Multivariate analysis revealed that UIP pattern in HRCT (Hazard ratio: 1.85; 95% Confidence interval = 1.14-3; P = .013), annual FVC (Hazard ratio: 0.521; 95% Confidence interval = 0.32-0.84; P = .007), and annual DLCO declines (Hazard ratio: 0.943; 95% Confidence interval = 0.897-0.991; P = .02) were independent risk factors for mortality in both CTD-ILD and IIP groups. We found that UIP pattern in HRCT and annual losses in respiratory functions were the main determinants of prognosis of ILDs either idiopathic or CTD-associated. SN - 2410-8650 UR - https://www.unboundmedicine.com/medline/citation/30913371/Comparison_of_clinical_courses_and_mortality_of_connective_tissue_disease_associated_interstitial_pneumonias_and_chronic_fibrosing_idiopathic_interstitial_pneumonias_ L2 - https://doi.org/10.1002/kjm2.12066 DB - PRIME DP - Unbound Medicine ER -