High-resolution computed tomography fibrosis score and pulmonary function tests in interstitial lung disease: Is there any correlation?

Fessi, R.; Ourari, B.; Amar, J. Ben; Zaibi, Haifa; Azzabi, Salwa; Baccar, M.A.; Aouina, H.

doi:10.1183/13993003.congress-2018.pa2926

Cited by 4 publications

(5 citation statements)

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“…In the current study, Warrick's score and its subscores (severity score, extent score, alveolitis score, and fibrosis score) were associated with a highly significant decrease in different pulmonary function indices (FVC, FEV 1 , TLC, and DLCO-SB). Previous studies showed the same results considering fibrosis score as interstitial score [22,23].…”

Section: Discussionsupporting

confidence: 66%

Diffusion lung capacity for carbon monoxide correlates with HRCT findings in patients with diffuse parenchymal lung disease

Hieba¹,

Shaimaa²,

Dina³

et al. 2020

Egypt J Bronchol

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Diffusion lung capacity for carbon monoxide correlates with HRCT findings in patients with diffuse parenchymal lung disease. Background Diffuse parenchymal lung diseases (DPLDs) affect the alveolar epithelium, pulmonary capillary endothelium, basement membrane, and perivascular and perilymphatic tissues. High-resolution computed tomography (HRCT) of the chest is the gold standard modality for diagnosing DPLD. Pulmonary function tests usually show a restrictive defect in spirometry. Single breath diffusion lung capacity for carbon monoxide (DLCO-SB) technique is used to assess the diffuse parenchymal lung diseases, as there is thickening of the alveolar membrane and diminished total lung capacity due to interstitial processes with severe decline in the transfer factor. The aim of this work was to correlate between Warrick’s HRCT fibrosis score and DLCO-SB in DPLD and to assess the possibility of using DLCO as an only tool to follow up DPLD to avoid repeated radiation exposure of the patients in HRCT chest (decrease need for radiological follow-up) or vice versa. Results This work recruited 89 patients over a period of 10 months duration, 74.2% of them were females. The Warrick’s score, ground-glass opacity, irregular pleural margin, subpleural cyst, honeycombing, and septal and subpleural lines were represented as 96.6%, 70.8%, 55.1%, 49.4%, and 48.3% respectively in HRCT of DPLD. Warrick’s score and its subscores (severity score, extent score, alveolitis score, and fibrosis score) were associated with a highly significant decrease in different pulmonary function indices (FVC, FEV1, TLC, and DLCO) with P value 0.001. A highly significant correlation between DLCO grades and total score grades was found with P value 0.001, and 86.8% of the patients with severe DLCO affection showed severe degree of total fibrosis score. Conclusions Both DLCO-SB and HRCT fibrosis scores were significantly correlated. Lifelong follow-up of function and structure of the lung in DPLD is needed by HRCT and DLCO. In an attempt to minimize repeated radiation exposure and reduce cost, we suggest DLCO to be used alone for longer follow-up periods rather than HRCT chest.

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Section: Discussionsupporting

confidence: 66%

Diffusion lung capacity for carbon monoxide correlates with HRCT findings in patients with diffuse parenchymal lung disease

Hieba¹,

Shaimaa²,

Dina³

et al. 2020

Egypt J Bronchol

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“…HRCT was scored by an experienced radiologist, who was aware of the RA diagnosis but was blinded to the clinical and laboratory data. ILD was diagnosed based on typical tomography pattern, defined as presence of diffuse peripheral or subpleural reticulation with or without honeycombing and ground-glass opacities [2,3,37]. On the basis of HRCT patients were classified as having ILD (ILD group) or not (N-ILD group).…”

Section: Methodsmentioning

confidence: 99%

“…On the basis of HRCT patients were classified as having ILD (ILD group) or not (N-ILD group). The ILD was graded using the semi-quantitative Warrick scale of fibrosis from 0 to 30 [37]. Warrick extent score (WES) and Warrick severity score (WSS) were calculated separately for each patient, then combined to obtain a global score (WGS).…”

Section: Methodsmentioning

confidence: 99%

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A dose-dependent beneficial effect of methotrexate on the risk of interstitial lung disease in rheumatoid arthritis patients

et al. 2021

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Objectives The aim of the study was to assess the influence of different factors, including treatment, on the risk of ILD in the course of RA. Methods A total of 109 RA patients were included in the analysis. High-resolution computed tomography (HRCT) of chest was obtained in each patient. Patients were classified as having ILD (ILD group) or not (N-ILD group). The ILD was graded using the semi-quantitative Warrick scale of fibrosis. Warrick extent score (WES) and Warrick severity score (WSS) were calculated separately for each patient, then combined to obtain a global score (WGS). Results In univariate analysis the presence of ILD was associated positively with age (P = 5x10-6) and negatively with MTX treatment (P = 0.0013), mean MTX dose per year of treatment (P = 0.003) and number of DMARDs used (P = 0.046). On multivariate analysis only age and treatment with MTX were independently associated with the presence of ILD. WGS was significantly lower in patients treated with MTX in a dose of ≥15 mg/week (MTX≥15 group) as compared to patients treated with lower doses of MTX (0<MTX<15 group) or not treated with MTX (N-MTX group) (P = 0.04 and P = 0.037, respectively). The ILD prevalence was higher in N-MTX group than in 0<MTX<15 group (P = 0.0036) and MTX≥15 group (0.0007). The difference in ILD prevalence between MTX≥15 and 0<MTX<15 groups was not significant, but the latter group had higher WES (P = 0.044) and trended to have higher WSS and WGS. Consclusions We found a beneficial effect of MTX on RA-ILD. Importantly, this effect seems to be dose dependent.

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“…HRCT even has the ability to identify subclinical cases before clinical presentation. 14 The presence of blood biomarkers, that could have an efficiency comparable to HRCT in detecting ILD associated with RA, would greatly facilitate the disease diagnosis and allow for early aggressive intervention prior to disease progression. 15 Krebs von den Lungen-6 (KL-6) is one of the mucins associated with respiratory cellular membranes.…”

Section: Introductionmentioning

confidence: 99%

Krebs von den Lungen‐6, a promising marker in evaluating the severity of interstitial lung disease in Egyptian rheumatoid arthritis patients

Hammoda¹,

Salah-ElDin²,

El-Gharbawy³

2021

EJI

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Krebs von den Lungen-6 (KL-6) is one of the mucins associated with interstitial lung disease. We aimed to assess the value of KL-6 as a marker for detecting the presence of interstitial lung disease in Egyptian rheumatoid arthritis patients and to evaluate its ability to assess severity in different grades of interstitial lung disease. The study included 89 rheumatoid arthritis patients; 64 patients with interstitial lung disease and 25 patients without interstitial lung disease. Serum levels of KL-6 were assessed using enzyme linked immunosorbent assay. Levels of KL-6 were higher in patients with interstitial lung disease compared to patients without interstitial lung disease (P< 0.001). KL-6 levels were significantly higher in grade 4 patients than those in grades 1 and 2. Also, KL-6 levels were significantly higher in grade 3 patients than those in grades 1 and 2. Kl-6 levels were also higher in grade 2 patients compared to grade 1 patients. Finally, no difference was observed between grade 4 patients and grade 3 patients. KL-6 levels were significantly higher in usual interstitial pneumonia pattern compared other patterns (P=0.015). In conclusion, KL-6 is a potential circulating biomarker that may have a substantial role in detecting the presence and evaluating the severity of interstitial lung disease among rheumatoid arthritis patients.

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High-resolution computed tomography fibrosis score and pulmonary function tests in interstitial lung disease: Is there any correlation?

Cited by 4 publications

References 0 publications

Diffusion lung capacity for carbon monoxide correlates with HRCT findings in patients with diffuse parenchymal lung disease

Diffusion lung capacity for carbon monoxide correlates with HRCT findings in patients with diffuse parenchymal lung disease

A dose-dependent beneficial effect of methotrexate on the risk of interstitial lung disease in rheumatoid arthritis patients

Krebs von den Lungen‐6, a promising marker in evaluating the severity of interstitial lung disease in Egyptian rheumatoid arthritis patients

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