Volume 41 Issue 12
Dec.  2019
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Zheng-cong CHEN, Zhao-xing DONG, Xiao-yuan ZHAO, Tao ZHANG. Clinical Characteristics of Interstitial Pneumonia with Autoimmune Features[J]. Journal of Kunming Medical University, 2020, 41(12): 23-28. doi: 10.12259/j.issn.2095-610X.S20201211
Citation: Zheng-cong CHEN, Zhao-xing DONG, Xiao-yuan ZHAO, Tao ZHANG. Clinical Characteristics of Interstitial Pneumonia with Autoimmune Features[J]. Journal of Kunming Medical University, 2020, 41(12): 23-28. doi: 10.12259/j.issn.2095-610X.S20201211

Clinical Characteristics of Interstitial Pneumonia with Autoimmune Features

doi: 10.12259/j.issn.2095-610X.S20201211
  • Received Date: 2020-04-16
  • Publish Date: 2019-12-26
  •   Objective   To explore the clinical features of interstitial pneumonia (IPAF) patients with autoimmune characteristics, and to compare the clinical difference between IPAF and non-IPAF-IIP (idiopathic interstitial pneumonia) and IPF (idiopathic pulmonary fibrosis).   Methods   Patients (n = 130) diagnosed with IIP consecutively in Department of Respiratory Medicine and Department of Rheumatology and Immunology of the Second Affiliated Hospital of Kunming Medical University from January 2014 to December 2019 were included, including 66 cases of IPAF, 64 cases of IIP that could not be diagnosed as IPAF (non-IPAF-IIP); and in the non-IPAF-IIP group, 42 patients in the IPF group were found to meet the IPF diagnosis. The demographics, clinical symptoms and signs, lab results and other clinical data of the patients were collected, and statistical analysis was conducted on the data of different indicators in each group to differentiate their characteristics.   Results   Among 130 IIP patients, 66 (50.8%) were reclassified as IPAF, and 42 (32.3%) were reclassified as IPF among non-IPAF-IIP (64 (49.2%)). IPAF diagnosis is mainly based on criteria in morphology and serology. Inflammatory arthritis or multi-joint morning stiffness ≥60 min, ANA and NSIP were the main manifestations in the three fields. Compared with non-IPAF-IIP and IPF, IPAF is more commonly seen in non-smoking female patients, with higher hormone using rate and higher DLCO, FVC and lower pulmonary artery pressure. The clinical manifestations of the three groups are similar, making it difficult to differentiate. Female, multiple chest lesions and clinical signs may be helpful for differential diagnosis. There is no significant difference in survival rate among the three groups (P > 0.05), but the median survival time of IPAF is higher than non-IPAF-IIP and IPF.   Conclusion   (1) IPAF diagnosis is mainly based on criteria in morphology and serology; (2) NSIP is the main type of HRCT, and ANA is the main serological type; (3) The hormone using rate of IPAF was significantly higher than non-IPAF-IIP and IPF.
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