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Predictive Factors for the Long-Term Deterioration of Pulmonary Function in Interstitial Lung Disease Associated with Anti-Aminoacyl-tRNA Synthetase Antibodies.
- Source :
-
Respiration; international review of thoracic diseases [Respiration] 2018; Vol. 96 (3), pp. 210-221. Date of Electronic Publication: 2018 May 16. - Publication Year :
- 2018
-
Abstract
- Background: Little has been reported on long-term pulmonary function trends among patients with interstitial lung disease associated with anti-aminoacyl-tRNA synthetase antibodies (ARS-ILD).<br />Objectives: To clarify the factors predictive of progression in ARS-ILD based on patients' initial clinical and radiological features.<br />Methods: The clinical courses of 88 patients with > 1 year of follow-up data on pulmonary function tests (PFTs) were retrospectively analyzed. Disease behavior was categorized into three groups: (1) improved or (2) worsened (defined as increases or decreases, respectively, of > 10% in forced vital capacity and > 15% in %diffusing capacity of lung carbon monoxide) or (3) stable based on PFT changes compared between 1-year results as the initial data and results at 3 years to assess the long-term course.<br />Results: In the initial course of 75 patients with ARS-ILD who received anti-inflammatory therapy within 6 months after diagnosis, 48 patients (64.0%) improved and 6 patients (8.0%) worsened. The radiological patterns in the patients with ARS-ILD included nonspecific interstitial pneumonia (NSIP) in 46.7% and NSIP with organizing pneumonia overlap in 52.0% of the cases. One-third of the initially improved patients who worsened over the long-term course were assigned to the unstable group. By multivariate logistic analysis, middle lobe traction bronchiectasis was a significant predictive factor for the patients in the unstable group.<br />Conclusions: Most patients with ARS-ILD receiving anti-inflammatory therapy had improved or remained stable in the first year. However, over the long-term course, some patients worsened despite their initial improvement. Even though the extent of the disease is limited, middle lobe traction bronchiectasis in ARS-ILD may be a useful predictor of poor long-term disease behavior.<br /> (© 2018 S. Karger AG, Basel.)
- Subjects :
- Aged
Anti-Inflammatory Agents therapeutic use
Disease Progression
Female
Humans
Lung Diseases, Interstitial diagnostic imaging
Lung Diseases, Interstitial drug therapy
Lung Diseases, Interstitial immunology
Male
Middle Aged
Radiography, Thoracic
Respiratory Function Tests
Retrospective Studies
Tomography, X-Ray Computed
Amino Acyl-tRNA Synthetases immunology
Lung physiopathology
Lung Diseases, Interstitial physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1423-0356
- Volume :
- 96
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Respiration; international review of thoracic diseases
- Publication Type :
- Academic Journal
- Accession number :
- 29768275
- Full Text :
- https://doi.org/10.1159/000488358