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Acute exacerbation of interstitial pneumonia associated with collagen vascular diseases

BACKGROUND: Acute exacerbation (AE) is currently established as a distinct condition with acute deterioration of respiratory status in idiopathic pulmonary fibrosis (IPF). Recently, several studies have reported that AE also occurred in interstitial pneumonias other than IPF, such as collagen vascul...

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Autores principales: Suda, Takafumi, Kaida, Yusuke, Nakamura, Yutaro, Enomoto, Noriyuki, Fujisawa, Tomoyuki, Imokawa, Shiro, Hashizume, Hideo, Naito, Tateaki, Hashimoto, Dai, Takehara, Yasuo, Inui, Naoki, Nakamura, Hirotoshi, Colby, Thomas V., Chida, Kingo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172557/
https://www.ncbi.nlm.nih.gov/pubmed/19181509
http://dx.doi.org/10.1016/j.rmed.2008.12.019
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author Suda, Takafumi
Kaida, Yusuke
Nakamura, Yutaro
Enomoto, Noriyuki
Fujisawa, Tomoyuki
Imokawa, Shiro
Hashizume, Hideo
Naito, Tateaki
Hashimoto, Dai
Takehara, Yasuo
Inui, Naoki
Nakamura, Hirotoshi
Colby, Thomas V.
Chida, Kingo
author_facet Suda, Takafumi
Kaida, Yusuke
Nakamura, Yutaro
Enomoto, Noriyuki
Fujisawa, Tomoyuki
Imokawa, Shiro
Hashizume, Hideo
Naito, Tateaki
Hashimoto, Dai
Takehara, Yasuo
Inui, Naoki
Nakamura, Hirotoshi
Colby, Thomas V.
Chida, Kingo
author_sort Suda, Takafumi
collection PubMed
description BACKGROUND: Acute exacerbation (AE) is currently established as a distinct condition with acute deterioration of respiratory status in idiopathic pulmonary fibrosis (IPF). Recently, several studies have reported that AE also occurred in interstitial pneumonias other than IPF, such as collagen vascular disease-associated interstitial pneumonia (CVD-IP). However, the incidence of AE in CVD-IP and its clinical characteristics remain to be fully determined. This study was conducted to elucidate cumulative incidence of AE in CVD-IP and its clinical features. METHODS: We reviewed 83 biopsy-proven CVD-IP patients, estimated cumulative incidence of AE, and examined its clinical characteristics. RESULTS: Among 83 CVD-IP patients, six patients with a mean age of 65.7 years developed AE (overall incidence, 7.2%; 1-year incidence, 1.25%). Underlying CVDs included rheumatoid arthritis (RA) (n = 5; overall incidence, 20.0%) and primary Sjögren syndrome (n = 1; overall incidence, 5.9%). Patients with AE showed acute respiratory deterioration with severe hypoxemia (mean PaO(2)/FiO(2) ratio, 131). Radiologically, ground-glass opacity was superimposed on the underlying reticular abnormalities. Preexisting histological patterns included three usual interstitial pneumonia (UIP) and two non-specific interstitial pneumonia (NSIP). Five (83.3%) of six patients died of respiratory failure despite intensive therapy. Univariate Cox's proportional hazards analysis showed that age and RA diagnosis were significantly associated with AE. Multivariate Cox's proportional hazards analysis indicated that age was an independent significant factor predicting AE. CONCLUSIONS: These data suggest that AE can occur in CVD-IP, and this condition is closely similar to that of IPF with poor prognosis. AE is most common in RA, and associated with higher ages.
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spelling pubmed-71725572020-04-22 Acute exacerbation of interstitial pneumonia associated with collagen vascular diseases Suda, Takafumi Kaida, Yusuke Nakamura, Yutaro Enomoto, Noriyuki Fujisawa, Tomoyuki Imokawa, Shiro Hashizume, Hideo Naito, Tateaki Hashimoto, Dai Takehara, Yasuo Inui, Naoki Nakamura, Hirotoshi Colby, Thomas V. Chida, Kingo Respir Med Article BACKGROUND: Acute exacerbation (AE) is currently established as a distinct condition with acute deterioration of respiratory status in idiopathic pulmonary fibrosis (IPF). Recently, several studies have reported that AE also occurred in interstitial pneumonias other than IPF, such as collagen vascular disease-associated interstitial pneumonia (CVD-IP). However, the incidence of AE in CVD-IP and its clinical characteristics remain to be fully determined. This study was conducted to elucidate cumulative incidence of AE in CVD-IP and its clinical features. METHODS: We reviewed 83 biopsy-proven CVD-IP patients, estimated cumulative incidence of AE, and examined its clinical characteristics. RESULTS: Among 83 CVD-IP patients, six patients with a mean age of 65.7 years developed AE (overall incidence, 7.2%; 1-year incidence, 1.25%). Underlying CVDs included rheumatoid arthritis (RA) (n = 5; overall incidence, 20.0%) and primary Sjögren syndrome (n = 1; overall incidence, 5.9%). Patients with AE showed acute respiratory deterioration with severe hypoxemia (mean PaO(2)/FiO(2) ratio, 131). Radiologically, ground-glass opacity was superimposed on the underlying reticular abnormalities. Preexisting histological patterns included three usual interstitial pneumonia (UIP) and two non-specific interstitial pneumonia (NSIP). Five (83.3%) of six patients died of respiratory failure despite intensive therapy. Univariate Cox's proportional hazards analysis showed that age and RA diagnosis were significantly associated with AE. Multivariate Cox's proportional hazards analysis indicated that age was an independent significant factor predicting AE. CONCLUSIONS: These data suggest that AE can occur in CVD-IP, and this condition is closely similar to that of IPF with poor prognosis. AE is most common in RA, and associated with higher ages. Elsevier Ltd. 2009-06 2009-02-01 /pmc/articles/PMC7172557/ /pubmed/19181509 http://dx.doi.org/10.1016/j.rmed.2008.12.019 Text en Copyright © 2009 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Suda, Takafumi
Kaida, Yusuke
Nakamura, Yutaro
Enomoto, Noriyuki
Fujisawa, Tomoyuki
Imokawa, Shiro
Hashizume, Hideo
Naito, Tateaki
Hashimoto, Dai
Takehara, Yasuo
Inui, Naoki
Nakamura, Hirotoshi
Colby, Thomas V.
Chida, Kingo
Acute exacerbation of interstitial pneumonia associated with collagen vascular diseases
title Acute exacerbation of interstitial pneumonia associated with collagen vascular diseases
title_full Acute exacerbation of interstitial pneumonia associated with collagen vascular diseases
title_fullStr Acute exacerbation of interstitial pneumonia associated with collagen vascular diseases
title_full_unstemmed Acute exacerbation of interstitial pneumonia associated with collagen vascular diseases
title_short Acute exacerbation of interstitial pneumonia associated with collagen vascular diseases
title_sort acute exacerbation of interstitial pneumonia associated with collagen vascular diseases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172557/
https://www.ncbi.nlm.nih.gov/pubmed/19181509
http://dx.doi.org/10.1016/j.rmed.2008.12.019
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