Abstract: Slide Presentations |

Value of cough and/or crackles in differential diagnosis of Interstitial lung diseases (ILD) FREE TO VIEW

Roberto G. Carbone, MD, FCCP*; Marco Musi, MD; Vito Privitera, MD; Giovanni Bottino, DSc
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Pneumology, Regional Hospital, Aosta, Italy


Chest. 2004;126(4_MeetingAbstracts):755S. doi:10.1378/chest.126.4_MeetingAbstracts.755S
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PURPOSE:  ILD are a spectrum of different nosographic entities, that can be differentiated on an etiologic and/or a histopathological ground. Little is known about specific differences in their clinical presentation.

METHODS:  We systematically checked for the presence of dry cough and/or fine crackles our series of 108 ILD patients (pts) affected with : sarcoidosis (Sarc), Wegener granulomatosis (WG), miliary tuberculosis (TB), extrinsic allergic alveolitis (EAA), usual interstitial pneumonia (UIP), non-specific interstitial pnemonia (NSIP) and post-attinic fibrosis (post-RT). All the diagnosis were biopsy-proven, except for TB and post-RT.

RESULTS:  Data are reported in the following table. n. of ptsCrackles % yesCough % yesSarc24013WG14079TB7057EAA10030UIP3410082NSIP133892post-RT61000Dyspnea is not included because it depends on the severity of the lung damage and not on its cause.The different nosographic entities show a quite typical pattern. In particular, crackles significantly differentiated granulomatous (Sarc, WG, TB, EAA) from non-granulomatous (UIP, NSIP, RT) diseases, and UIP from NSIP (X2 : p<0.01). Cough was more prevalent among WG than among Sarc pts (X2 : p<0.01), but not different comparing UIP and NSIP pts (X2 : NS). Interestingly, among 10 pts affected whit systemic sclerosis (not shown as a specific group), histopathologic pattern (5 UIP and 5 NSIP) was predictive of the presence of crackles (100% and 40% respectively, as for the general UIP and NSIP series), within the same etiologic group.

CONCLUSION:  These data demonstrate that crackles and cough show distinctive patterns and turn out to be powerful diagnostic tools in ILD. Since we refer to a population of pts with long lasting ILD, we can not extend these features to early ILD (for differential diagnosis) nor to different phases of ILD clinical evolution.

CLINICAL IMPLICATIONS:  In addition to imaging and functional tests, clinicians dealing with ILD pts should consider the clinical relevance of cough and crackles, that are simple and inexpensive parameters.

DISCLOSURE:  R.G. Carbone, None.

Tuesday, October 26, 2004

12:30 PM- 2:00 PM




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