Differences in clinical features of acute exacerbation between connective tissue disease-associated interstitial pneumonia and idiopathic pulmonary fibrosis

被引：29

作者：

Enomoto, Noriyuki ^{[1
,2
]}

Oyama, Yoshiyuki ^{[1
]}

Enomoto, Yasunori ^{[1
]}

Yasui, Hideki ^{[1
]}

Karayama, Masato ^{[1
]}

Kono, Masato ^{[1
]}

Hozumi, Hironao ^{[1
]}

Suzuki, Yuzo ^{[1
]}

Furuhashi, Kazuki ^{[1
]}

Fujisawa, Tomoyuki ^{[1
]}

Inui, Naoki ^{[1
,3
]}

Nakamura, Yutaro ^{[1
]}

Suda, Takafumi ^{[1
]}

机构：

[1] Hamamatsu Univ Sch Med, Div 2, Dept Internal Med, Hamamatsu, Shizuoka, Japan

[2] Hamamatsu Univ Sch Med, Hlth Adm Ctr, Hamamatsu, Shizuoka, Japan

[3] Hamamatsu Univ Sch Med, Dept Clin Pharmacol & Therapeut, Hamamatsu, Shizuoka, Japan

来源：

CHRONIC RESPIRATORY DISEASE | 2018年 / 16卷

基金：

日本学术振兴会;

关键词：

Connective tissue disease; interstitial pneumonia; acute exacerbation; idiopathic pulmonary fibrosis; rheumatoid arthritis; RISK-FACTORS;

D O I：

10.1177/1479972318809476

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a devastating condition that frequently occurs in the advanced stage of IPF. However, the clinical features in AE of connective tissue disease-associated interstitial pneumonia (AE-CTD-IP) have not been well-established. The aim of this study was to clarify the clinical features of AE-CTD-IP and to compare them with those of AE-IPF. Fifteen AE-CTD-IP patients and 48 AE-IPF patients who were diagnosed and treated at our hospital were retrospectively studied. Compared with AE-IPF patients, AE-CTD-IP patients had a significantly higher %FVC (median, 94.8 vs. 56.3%; p < 0.001) and a lower extent of honeycombing on HRCT (p = 0.020) within 1 year before AE. At AE, AE-CTD-IP patients showed higher white blood cell counts (12.0 vs. 9.9 x 10(3)/mu L; p = 0.023), higher CRP (10.2 vs. 6.7 mg/dL; p = 0.027), and longer period from admission to the beginning of AE treatment (4 vs. 1 days; p = 0.003) than AE-IPF patients. In addition, patients with AE-CTD-IP had poor prognosis as in those with AE-IPF (log-rank; p = 0.171). In conclusion, AE-CTD-IP occurred even in the early stage of IP and had more inflammatory status than in AE-IPF.

引用

页数：8

共 20 条

[1] Computed tomography findings in acute exacerbation of idiopathic pulmonary fibrosis [J].

Akira, Masanori ;

Kozuka, Takenori ;

Yamamoto, Satoru ;

Sakatani, Mitsunori .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2008, 178 (04) :372-378

[2] Acute exacerbations of idiopathic pulmonary fibrosis [J].

Collard, Harold R. ;

Moore, Bethany B. ;

Flaherty, Kevin R. ;

Brown, Kevin K. ;

Kaner, Robert J. ;

King, Talmadge E., Jr. ;

Lasky, Joseph A. ;

Loyd, James E. ;

Noth, Imre ;

Olman, Mitchell A. ;

Raghu, Ganesh ;

Roman, Jesse ;

Ryu, Jay H. ;

Zisman, David A. ;

Hunninghake, Gary W. ;

Colby, Thomas V. ;

Egan, Jim J. ;

Hansell, David M. ;

Johkoh, Takeshi ;

Kaminski, Naftali ;

Kim, Dong Soon ;

Kondoh, Yasuhiro ;

Lynch, David A. ;

Mueller-Quernheim, Joachim ;

Myers, Jeffrey L. ;

Nicholson, Andrew G. ;

Selman, Moises ;

Toews, Galen B. ;

Wells, Athol U. ;

Martinez, Fernando J. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2007, 176 (07) :636-643

[3] Acute Exacerbation of Idiopathic Pulmonary Fibrosis An International Working Group Report [J].

Collard, Harold R. ;

Ryerson, Christopher J. ;

Corte, Tamera J. ;

Jenkins, Gisli ;

Kondoh, Yasuhiro ;

Lederer, David J. ;

Lee, Joyce S. ;

Maher, Toby M. ;

Wells, Athol U. ;

Antoniou, Katerina M. ;

Behr, Juergen ;

Brown, Kevin K. ;

Cottin, Vincent ;

Flaherty, Kevin R. ;

Fukuoka, Junya ;

Hansell, David M. ;

Johkoh, Takeshi ;

Kaminski, Naftali ;

Kim, Dong Soon ;

Kolb, Martin ;

Lynch, David A. ;

Myers, Jeffrey L. ;

Raghu, Ganesh ;

Richeldi, Luca ;

Taniguchi, Hiroyuki ;

Martinez, Fernando J. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2016, 194 (03) :265-275

[4] Possible therapeutic effect of direct haemoperfusion with a polymyxin B immobilized fibre column (PMX-DHP) on pulmonary oxygenation in acute exacerbations of interstitial pneumonia [J].

Enomoto, Noriyuki ;

Suda, Takafumi ;

Uto, Tomohiro ;

Kato, Masato ;

Kaida, Yusuke ;

Ozawa, Yuichi ;

Miyazaki, Hiroo ;

Kuroishi, Shigeki ;

Hashimoto, Dai ;

Naito, Tateaki ;

Fujisawa, Tomoyuki ;

Matsui, Takashi ;

Inui, Naoki ;

Nakamura, Yutaro ;

Sato, June ;

Mizuguchi, Tomoaki ;

Kato, Akihiko ;

Chida, Kingo .

RESPIROLOGY, 2008, 13 (03) :452-460

[5] Treatment of acute exacerbation of idiopathic pulmonary fibrosis with direct hemoperfusion using a polymyxin B-immobilized fiber column improves survival [J].

Enomoto, Noriyuki ;

Mikamo, Masashi ;

Oyama, Yoshiyuki ;

Kono, Masato ;

Hashimoto, Dai ;

Fujisawa, Tomoyuki ;

Inui, Naoki ;

Nakamura, Yutaro ;

Yasuda, Hideo ;

Kato, Akihiko ;

Mimuro, Soichiro ;

Doi, Matsuyuki ;

Sato, Shigehito ;

Suda, Takafumi .

BMC PULMONARY MEDICINE, 2015, 15

[6] The usefulness of a disease severity staging classification system for IPF in Japan: 20 years of experience from empirical evidence to randomized control trial enrollment [J].

Homma, Sakae ;

Sugino, Keishi ;

Sakamoto, Susumu .

RESPIRATORY INVESTIGATION, 2015, 53 (01) :7-12

[7] Recombinant Human Thrombomodulin in Acute Exacerbation of Idiopathic Pulmonary Fibrosis [J].

Kataoka, Kensuke ;

Taniguchi, Hiroyuki ;

Kondoh, Yasuhiro ;

Nishiyama, Osamu ;

Kimura, Tomoki ;

Matsuda, Toshiaki ;

Yokoyama, Toshiki ;

Sakamoto, Koji ;

Ando, Masahiko .

CHEST, 2015, 148 (02) :436-443

[8] Acute exacerbation of idiopathic pulmonary fibrosis: frequency and clinical features [J].

Kim, DS ;

Park, JH ;

Park, BK ;

Lee, JS ;

Nicholson, AG ;

Colby, T .

EUROPEAN RESPIRATORY JOURNAL, 2006, 27 (01) :143-150

[9]

Kondoh Y, 2010, SARCOIDOSIS VASC DIF, V27, P103

[10] ACUTE EXACERBATION IN IDIOPATHIC PULMONARY FIBROSIS - ANALYSIS OF CLINICAL AND PATHOLOGICAL FINDINGS IN 3 CASES [J].

KONDOH, Y ;

TANIGUCHI, H ;

KAWABATA, Y ;

YOKOI, T ;

SUZUKI, K ;

TAKAGI, K .

CHEST, 1993, 103 (06) :1808-1812

← 1 2 →