Multicenter Registry of Interstitial Lung Diseases in Adults in Brazil

Pereira, CA; Soares, Maria Raquel; Botelho, André Bezerra; Gimenez, Andréa; Beraldo, Bruno Leôncio De Moraes; Fukuda, Cesar; Castro, Marina Dornfeld Cunha; Cerezoli, Milena Tenório; Gomes, Paulo de Oliveira; Martins, Rafaela Boaventura; Mancuzo, Eliane Viana; Moreira, Maria Auxiliadora Carmo; Storrer, Karin Mueller

doi:10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a3352

Cited by 3 publications

(7 citation statements)

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“…In Brazil, HP is more common than IPF as a cause of ILD (24 vs 10%), as shown in a recent multicentre study [7]. However, 53% of all patients with ILD had potential exposure to HP, raising the question of whether other diagnoses can be excluded simply by the presence of environmental antigens.…”

Section: Discussionmentioning

confidence: 97%

“…The test characteristics of the probable UIP pattern (sensitivity, specificity and positive predictive value) for histopathological UIP were calculated using the prevalence of IPF observed in Brazil (10%) and in other countries with the highest prevalence [7,23,24].…”

Section: Discussionmentioning

confidence: 99%

“…In that study, the second most common diagnosis was hypersensitivity pneumonitis (HP). In Brazil, HP is a common cause of ILD [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical diagnosis of patients subjected to surgical lung biopsy with a probable usual interstitial pneumonia pattern on high-resolution computed tomography

et al. 2020

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Background Usual interstitial pneumonia can present with a probable pattern on high-resolution computed tomography (HRCT), but the probability of identifying usual interstitial pneumonia by surgical lung biopsy in such cases remains controversial. We aimed to determine the final clinical diagnosis in patients with a probable usual interstitial pneumonia pattern on HRCT who were subjected to surgical lung biopsy. Methods HRCT images were assessed and categorized by three radiologists, and tissue slides were evaluated by two pathologists, all of whom were blinded to the clinical findings. The final clinical diagnosis was accomplished via a multidisciplinary discussion. Patients with a single layer of honeycombing located outside of the lower lobes on HRCT were not excluded. Results A total of 50 patients were evaluated. The most common final clinical diagnosis was fibrotic hypersensitivity pneumonitis (38.0%) followed by idiopathic pulmonary fibrosis (24.0%), interstitial lung disease ascribed to gastroesophageal reflux disease (12.0%) and familial interstitial lung disease (10.0%). In the group without environmental exposure (n = 22), 10 patients had a final clinical diagnosis of idiopathic pulmonary fibrosis (45.5%). Irrespective of the final clinical diagnosis, by multivariate Cox analysis, patients with honeycombing, dyspnoea and fibroblastic foci on surgical lung biopsy had a high risk of death. Conclusions The most common disease associated with a probable usual interstitial pneumonia pattern on HRCT is fibrotic hypersensitivity pneumonitis followed by idiopathic pulmonary fibrosis and interstitial lung disease ascribed to gastroesophageal reflux disease. In patients without environmental exposure, the frequencies of usual interstitial pneumonia and a final clinical diagnosis of idiopathic pulmonary fibrosis are not sufficiently high to obviate the indications for surgical lung biopsy.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Clinical diagnosis of patients subjected to surgical lung biopsy with a probable usual interstitial pneumonia pattern on high-resolution computed tomography

et al. 2020

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“…The test characteristics of the probable UIP pattern (sensitivity, speci city and positive predictive value) for histopathological UIP were calculated using the prevalence of IPF observed in Brazil (10%) and in other countries with the highest prevalence. (7,22,23) Survival time was calculated from the date of biopsy to death, lung transplantation (n = 1) or loss to follow-up. The survival status was obtained from telephone interviews and/or medical records.…”

Section: Histologic Evaluationmentioning

confidence: 99%

“…In Brazil, HP is a common cause of ILD. (7) More recently, the Fleischner Society and ATS/ERS/JTS/ALAT guidelines suggested four categories for classifying HRCT patterns of UIP. (8,9) In the absence of honeycombing and in the appropriate clinical context, a reticular pattern with lower lobe predominance and traction bronchiectasis should be considered not a possible UIP pattern but a probable UIP pattern.…”

Section: Introductionmentioning

confidence: 99%

Clinical diagnosis of patients subjected to surgical lung biopsy with a probable usual interstitial pneumonia pattern on high-resolution computed tomography

Tibana

Soares

Storrer

et al. 2020

Preprint

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Background: Usual interstitial pneumonia (UIP) can present with a probable pattern on high-resolution computed tomography (HRCT), but the probability of UIP by surgical lung biopsy in such cases remains controversial. We aimed to determine the final clinical diagnosis in patients with a probable UIP pattern on HRCT subjected to surgical lung biopsy.Methods: HRCT images were assessed and categorized by three radiologists, and tissue slides were evaluated by two pathologists, all of whom were blinded to the clinical findings. The final clinical diagnosis was accomplished via a multidisciplinary discussion. Patients with a single layer of honeycombing located outside of the lower lobes on HRCT were not excluded.Results: A total of 50 patients were evaluated. The most common final clinical diagnosis was fibrotic hypersensitivity pneumonitis (38.0%; 95% CI: 24.7% to 52.8%), followed by idiopathic pulmonary fibrosis (24.0%; 95% CI: 13.1% to 38.2%) and interstitial lung disease ascribed to gastroesophageal reflux disease (12.0%; 95% CI: 4.5% to 24.3%) and familial interstitial lung disease (10.0%; 95% CI: 3.3% to 21.8%). In the group without environmental exposure (n = 22), 10 patients had a final clinical diagnosis of idiopathic pulmonary fibrosis (45.5%; 95% CI: 24.4% to 67.8%). Irrespective of the final clinical diagnosis, by multivariate Cox analysis, patients with honeycombing, dyspnoea and the presence of fibroblastic foci on surgical lung biopsy had a high risk of death.Conclusions: The most common disease associated with a probable UIP pattern on HRCT is fibrotic hypersensitivity pneumonitis, followed by idiopathic pulmonary fibrosis and interstitial lung disease ascribed to gastroesophageal reflux disease. In patients without environmental exposure, the frequency of UIP and a final clinical diagnosis of idiopathic pulmonary fibrosis are not sufficiently high to obviate the indication for surgical lung biopsy.

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Sleep parameters in patients with chronic hypersensitivity pneumonitis: a case-control study

Boaventura Martins1,

Rita Azeredo Bittencourt2,

Bezerra Botelho1

et al. 2023

J Bras Pneumol.

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Objective: To compare patients with chronic hypersensitivity pneumonitis (cHP) and controls with normal spirometry in terms of their sleep characteristics, as well as to establish the prevalence of obstructive sleep apnea (OSA) and nocturnal hypoxemia. Secondary objectives were to identify factors associated with OSA and nocturnal hypoxemia; to correlate nocturnal hypoxemia with the apnea-hypopnea index (AHI) and lung function, as well as with resting SpO2, awake SpO2, and SpO2 during exercise; and to evaluate the discriminatory power of sleep questionnaires to predict OSA. Methods: A total of 40 patients with cHP (cases) were matched for sex, age, and BMI with 80 controls, the ratio of controls to cases therefore being = 2:1. The STOP-Bang questionnaire, the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index, the Berlin questionnaire and the Neck circumference, obesity, Snoring, Age, and Sex (NoSAS) score were applied to all cases, and both groups underwent full-night polysomnography. Results: The patients with cHP had longer sleep latency, lower sleep efficiency, a lower AHI, a lower respiratory disturbance index, fewer central apneas, fewer mixed apneas, and fewer hypopneas than did the controls. The patients with cHP had significantly lower nocturnal SpO2 values, the percentage of total sleep time spent below an SpO2 of 90% being higher than in controls (median = 4.2; IQR, 0.4-32.1 vs. median = 1.0; IQR, 0.1-5.8; p = 0.01). There were no significant differences between cases with and without OSA regarding the STOP-Bang questionnaire, NoSAS, and ESS scores. Conclusions: The prevalence of OSA in cHP patients (cases) was high, although not higher than that in controls with normal spirometry. In addition, cases had more hypoxemia during sleep than did controls. Our results suggest that sleep questionnaires do not have sufficient discriminatory power to identify OSA in cHP patients.

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Multicenter Registry of Interstitial Lung Diseases in Adults in Brazil

Cited by 3 publications

References 0 publications

Clinical diagnosis of patients subjected to surgical lung biopsy with a probable usual interstitial pneumonia pattern on high-resolution computed tomography

Clinical diagnosis of patients subjected to surgical lung biopsy with a probable usual interstitial pneumonia pattern on high-resolution computed tomography

Clinical diagnosis of patients subjected to surgical lung biopsy with a probable usual interstitial pneumonia pattern on high-resolution computed tomography

Sleep parameters in patients with chronic hypersensitivity pneumonitis: a case-control study

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