Diffuse Lung Disease: Connective Tissue-Associated Interstitial Lung Disease |

Clinical and Functional Behavior in Interstitial Lung Diseases Associated to Connective Tissue Diseases FREE TO VIEW

Brenda Varela, MD; Gabriela Tabaj, MD; Maria Victoria Gallardo, MD; Mariana Salomon, MD; Cecilia Gonzalez Ginestet, MD; Georgina Gramblicka, MD; Alejandro Nitsche, MD; Carlos Alberto Nigro
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Hospital Aleman, CABA, Argentina

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):477A. doi:10.1016/j.chest.2016.08.491
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SESSION TITLE: Connective Tissue-Associated Interstitial Lung Disease

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Primary objective: To compare clinical and functional characteristics between interstitial lung diseases associated to connective tissue diseases (CTD-ILD) and idiopathic pulmonary fibrosis (IPF) Secondary objective: to evaluate functional behavior between to subtypes of CTD-ILD: systemic sclerosis (SS) and rheumatoid arthritis (RA).

METHODS: Patients with diagnosis of ILD were analyzed during the period 2014-2015. Clinical and laboratory data, rheumatic profile and tomographic patterns were ascertained. The difference between the initial forced vital capacity (FVC) expressed in percentage of predicted value, and the value obtained in the sixth month was evaluated by FVC Delta (FVCi FVE6m/FVCI*100). Descriptive and comparative analysis was performed. The values were expressed as percentages and mean (Standard Deviation). t Test-way ANOVA and Chi square was used to compare the study variables.

RESULTS: 199 patients with ILD were in total evaluated. From them, 88 were included in one of following categories: 43 IPF and 45 CTD-ILD. The age of presentation was higher in patients with IPF (70.32 vs 62.35 for CTD-ILD; p 0.0010) and there was a predominance of woman in the CTD-ILD group (77.77% vs 41.83% for IPF; p 0.0013). Both, the percentage of FVC and DLCO, were higher in the group of CTD-ILD than IPF (75.95 % vs 64.17% for FVC; p 0.036 and 54.11% VS 39.73% for DLCO; p 0.0018). The presence of velcro rales in auscultation were observed in the totality of patients with IPF (100% vs 46.6% for CTD-ILD; p<0.001). Arthralgia, gastroesophageal reflux and Raynauds phenomenon were the symptom more frequent in CTD-ILD. The predominant auto-antibody in the CTD-ILD was antibody anti-nuclear (ANA) (48.8% vs 16.2% in IPF; p 0.002). The tomographic pattern more frequent in the CTD-ILD was NSIP pattern (35.55% vs 4.6% in IPF). Contrary, in IPF, the dominants patterns were definitive UIP, possible UIP and combinations of UIP and emphysema (83.7%, 11.6% and 32.5%). The fall of Delta FVC was higher for patients with IPF and in the subgroups analysis of CTD-ILD, there was a greater drop in FVC in patients with RA than in SS (Drop in Delta FCV in percentage 7.04% for IPF, 4.85% for RA and 0.28% for SSc; p 0.94).

CONCLUSIONS: The clinical and functional characteristics are different in both groups. When subgroups of CTD-ILD are analyzed different clinical, tomographic and functional characteristics were found.

CLINICAL IMPLICATIONS: The CTD-ILD usually distinctive IPF and have a less severe than the IPF functional behavior.

DISCLOSURE: The following authors have nothing to disclose: Brenda Varela, Gabriela Tabaj, Maria Victoria Gallardo, Mariana Salomon, Cecilia Gonzalez Ginestet, Georgina Gramblicka, Alejandro Nitsche, Carlos Alberto Nigro

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