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Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases

Interstitial lung diseases (ILDs) comprise a wide group of pulmonary parenchymal disorders. These patients may experience acute respiratory deteriorations of their respiratory condition, termed “acute exacerbation” (AE). The incidence of AE-ILD seems to be lower than idiopathic pulmonary fibrosis (I...

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Autores principales: Faverio, Paola, Stainer, Anna, Conti, Sara, Madotto, Fabiana, De Giacomi, Federica, Della Zoppa, Matteo, Vancheri, Ada, Pellegrino, Maria Rosaria, Tonelli, Roberto, Cerri, Stefania, Clini, Enrico M., Mantovani, Lorenzo Giovanni, Pesci, Alberto, Luppi, Fabrizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8465527/
https://www.ncbi.nlm.nih.gov/pubmed/34573965
http://dx.doi.org/10.3390/diagnostics11091623
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author Faverio, Paola
Stainer, Anna
Conti, Sara
Madotto, Fabiana
De Giacomi, Federica
Della Zoppa, Matteo
Vancheri, Ada
Pellegrino, Maria Rosaria
Tonelli, Roberto
Cerri, Stefania
Clini, Enrico M.
Mantovani, Lorenzo Giovanni
Pesci, Alberto
Luppi, Fabrizio
author_facet Faverio, Paola
Stainer, Anna
Conti, Sara
Madotto, Fabiana
De Giacomi, Federica
Della Zoppa, Matteo
Vancheri, Ada
Pellegrino, Maria Rosaria
Tonelli, Roberto
Cerri, Stefania
Clini, Enrico M.
Mantovani, Lorenzo Giovanni
Pesci, Alberto
Luppi, Fabrizio
author_sort Faverio, Paola
collection PubMed
description Interstitial lung diseases (ILDs) comprise a wide group of pulmonary parenchymal disorders. These patients may experience acute respiratory deteriorations of their respiratory condition, termed “acute exacerbation” (AE). The incidence of AE-ILD seems to be lower than idiopathic pulmonary fibrosis (IPF), but prognosis and prognostic factors are largely unrecognized. We retrospectively analyzed a cohort of 158 consecutive adult patients hospitalized for AE-ILD in two Italian university hospitals from 2009 to 2016. Patients included in the analysis were divided into two groups: non-IPF (62%) and IPF (38%). Among ILDs included in the non-IPF group, the most frequent diagnoses were non-specific interstitial pneumonia (NSIP) (42%) and connective tissue disease (CTD)-ILD (20%). Mortality during hospitalization was significantly different between the two groups: 19% in the non-IPF group and 43% in the IPF group. AEs of ILDs are difficult-to-predict events and are burdened by relevant mortality. Increased inflammatory markers, such as neutrophilia on the differential blood cell count (HR 1.02 (CI 1.01–1.04)), the presence of pulmonary hypertension (HR 1.85 (CI 1.17–2.92)), and the diagnosis of IPF (HR 2.31 (CI 1.55–3.46)), resulted in negative prognostic factors in our analysis. Otherwise, lymphocytosis on the differential count seemed to act as a protective prognostic factor (OR 0.938 (CI 0.884–0.995)). Further prospective, large-scale, real-world data are needed to support and confirm the impact of our findings.
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spelling pubmed-84655272021-09-27 Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases Faverio, Paola Stainer, Anna Conti, Sara Madotto, Fabiana De Giacomi, Federica Della Zoppa, Matteo Vancheri, Ada Pellegrino, Maria Rosaria Tonelli, Roberto Cerri, Stefania Clini, Enrico M. Mantovani, Lorenzo Giovanni Pesci, Alberto Luppi, Fabrizio Diagnostics (Basel) Article Interstitial lung diseases (ILDs) comprise a wide group of pulmonary parenchymal disorders. These patients may experience acute respiratory deteriorations of their respiratory condition, termed “acute exacerbation” (AE). The incidence of AE-ILD seems to be lower than idiopathic pulmonary fibrosis (IPF), but prognosis and prognostic factors are largely unrecognized. We retrospectively analyzed a cohort of 158 consecutive adult patients hospitalized for AE-ILD in two Italian university hospitals from 2009 to 2016. Patients included in the analysis were divided into two groups: non-IPF (62%) and IPF (38%). Among ILDs included in the non-IPF group, the most frequent diagnoses were non-specific interstitial pneumonia (NSIP) (42%) and connective tissue disease (CTD)-ILD (20%). Mortality during hospitalization was significantly different between the two groups: 19% in the non-IPF group and 43% in the IPF group. AEs of ILDs are difficult-to-predict events and are burdened by relevant mortality. Increased inflammatory markers, such as neutrophilia on the differential blood cell count (HR 1.02 (CI 1.01–1.04)), the presence of pulmonary hypertension (HR 1.85 (CI 1.17–2.92)), and the diagnosis of IPF (HR 2.31 (CI 1.55–3.46)), resulted in negative prognostic factors in our analysis. Otherwise, lymphocytosis on the differential count seemed to act as a protective prognostic factor (OR 0.938 (CI 0.884–0.995)). Further prospective, large-scale, real-world data are needed to support and confirm the impact of our findings. MDPI 2021-09-06 /pmc/articles/PMC8465527/ /pubmed/34573965 http://dx.doi.org/10.3390/diagnostics11091623 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Faverio, Paola
Stainer, Anna
Conti, Sara
Madotto, Fabiana
De Giacomi, Federica
Della Zoppa, Matteo
Vancheri, Ada
Pellegrino, Maria Rosaria
Tonelli, Roberto
Cerri, Stefania
Clini, Enrico M.
Mantovani, Lorenzo Giovanni
Pesci, Alberto
Luppi, Fabrizio
Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases
title Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases
title_full Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases
title_fullStr Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases
title_full_unstemmed Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases
title_short Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases
title_sort differences between acute exacerbations of idiopathic pulmonary fibrosis and other interstitial lung diseases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8465527/
https://www.ncbi.nlm.nih.gov/pubmed/34573965
http://dx.doi.org/10.3390/diagnostics11091623
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