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- Title
Heterogeneity of incidence and outcome of acute exacerbation in idiopathic interstitial pneumonia.
- Authors
Arai, Toru; Kagawa, Tomoko; Sasaki, Yumiko; Sugawara, Reiko; Sugimoto, Chikatoshi; Tachibana, Kazunobu; Kitaichi, Masanori; Akira, Masanori; Hayashi, Seiji; Inoue, Yoshikazu
- Abstract
ABSTRACT Background and objective Acute exacerbations ( AEs) of idiopathic pulmonary fibrosis ( IPF) and other idiopathic interstitial pneumonia ( IIP) have a poor prognosis. This study aims to clarify the incidence and prognosis of AE in IPF and the other IIP. Methods A total of 229 patients were enrolled, of whom 92 had IPF and 137 had ' IIP other than IPF' based on the American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Association ( ATS/ ERS/ JRS/ ALAT) 2011 IPF Guidelines. IIP other than IPF included 11 patients with a surgical lung biopsy ( SLB) and the remainder without such a biopsy. IIP other than IPF was further classified into IIP with a 'possible usual interstitial pneumonia ( UIP)' pattern on HRCT ( n = 75) and IIP with 'inconsistent with UIP' pattern ( n = 62) based on published guidelines. Predictors of AE and the prognosis after AE were examined in these groups. Results The 1-year incidence of AE in IPF, IIP with possible UIP HRCT patterns and IIP with inconsistent with UIP HRCT patterns was 16.5%, 8.9% and 4.0%, respectively. AE occurred significantly more frequently in IPF than in IIP with possible UIP and inconsistent with UIP HRCT patterns after adjustment for BMI, modified Medical Research Council score and %forced vital capacity. Prognosis of AE-IIP with possible UIP HRCT pattern was significantly worse than that of AE-IPF. Conclusion Although AE occurred significantly less frequently in IIP with possible UIP and inconsistent with UIP HRCT patterns than in IPF, the prognosis of AE-IIP with possible UIP HRCT patterns might be worse than that of AE-IPF.
- Subjects
IDIOPATHIC pulmonary fibrosis; IDIOPATHIC interstitial pneumonias; LUNG biopsy; VITAL capacity (Respiration); RESPIRATORY measurements; PROGNOSIS
- Publication
Respirology, 2016, Vol 21, Issue 8, p1431
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.12862