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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Prognostic factors in rapidly progressive interstitial pneumonia
Yasuhiro Kondoh1, Hiroyuki Taniguchi, Kensuke Kataoka
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan.
Respirology (Carlton, Vic.)
|January 15, 2010
Summary
Histological diagnosis is the key to predicting outcomes in rapidly progressive interstitial pneumonia (RPIP). Baseline clinical data cannot distinguish between different RPIP patterns, but histology reliably determines prognosis.
Area of Science:
- Pulmonary Medicine
- Pathology
- Interventional Pulmonology
Background:
- Rapidly progressive interstitial pneumonia (RPIP) presents with diverse histological patterns and outcomes.
- Distinguishing between these patterns and predicting prognosis based on initial clinical data is challenging.
Purpose of the Study:
- To identify clinical and investigative features for prognostic distinctions in RPIP.
- To assess prognostic factors for survival in RPIP patients.
- To compare outcomes between diffuse alveolar damage (DAD)/usual interstitial pneumonia with DAD pattern (Group A) and organizing pneumonia/non-specific interstitial pneumonia pattern (Group B).
Main Methods:
- Retrospective analysis of 425 patients with diffuse lung disease undergoing surgical lung biopsy.
- Evaluation of discriminatory value of clinical and investigative features for prognosis.
- A priori comparison between Group A (DAD/UIP with DAD) and Group B (OP/NSIP) RPIP patterns.
Main Results:
- Twenty-eight patients (6.6%) met RPIP criteria, with 15 in Group A and 13 in Group B.
- No significant differences in initial findings between Group A and Group B.
- Group B patients had a significantly better prognosis than Group A patients (P=0.021).
- Neither BAL nor HRCT scores predicted outcome; histological pattern was the sole significant prognostic determinant.
Conclusions:
- RPIP encompasses varied histological patterns with differing prognoses.
- Baseline clinical data are insufficient for predicting RPIP outcomes.
- Histological diagnosis is the only reliable predictor of prognosis in RPIP.
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