Romatoloji Pratiğinde İnterstitiel Akciğer Hastalığı: Tek Merkez Deneyimi

Yıl 2017, Cilt: 3 Sayı: 2, 71 - 82, 01.01.2017

Funda Erbasan Şuayp Oygen Edip Gökalp Gök Gökhan Tazegül Mustafa Ender Terzioğlu Veli Yazısız

Öz

Amaç: İnterstitiel akciğer hastalığı İAH akciğerlerdeki interstitiel aralığı etkileyen heterojen bir hastalık grubudur. İAH bağ doku hastalıklarına BDH sekonder gelişebilir ve solunum yetmezliğinden dolayı sakatlık ve ölüm oranı artar. Bu çalışmanın amacı BDH ilişkili İAH'nın klinik, laboratuvar ve görüntüleme özelliklerini tanımlamak ve tedavi yaklaşımlarını analiz etmektir. Gereç ve Yöntemler: Bu çalışmaya ardışık gelen 132 İAH hastası alındı. Demografik özellikleri, laboratuvar ve yüksek rezolüsyonlu akciğer tomografisi HRCT ve tedavi sonuçları analiz edildi. bulgular: BDH ilişkili İAH tanısı alan 99 hasta vardı. Ortalama yaş 54.7±11.6 yıl, kadın oranı %82.8, median takip süresi 48.5 aydı. 96 hastanın takip süresi altı aydan fazlaydı. HRCT taramaları median 12.5 aylık intervaller ile median 3 kez tekrarlanmıştı. En sık HRCT bulguları buzlu cam opasiteleri ve interlobüler septal kalınlaşmalardır. Hastaların üçte birinde bal peteği paterni vardı. Hastaların %89.6'sı kortikosteroid %44.8'i antimalaryal ajan almıştı. Azatiopürin ve siklofosfamid en sık kullanılan immünosupresif ilaçlardı. Tedavi sonrası ortalama solunum fonksiyon testleri tedavi monoxide DLCO are used for monitorization. Reduced FVC levels show advanced disease and more than 10% decrease is related with poor prognosis 19 . HRCT also correlates with spirometric measurements and may be used in follow-up 20 . Connective tissue diseases are a principal group of rheumatologic diseases and they constitute an important part of rheumatological practice. Pulmonary symptoms of these patients require a good differential diagnosis and treatment approach. Although there are a number of recent studies focusing on CTD-ILDs, there is no consensus on the diagnosis, follow-up and treatment of these patients. In this study, we aim to present a single rheumatology center clinical experience of patients with ILD. Furthermore, we reported the clinical, laboratory, imaging results and treatment approaches of patients with CTD-ILD.MAtErIAL and MEtHODSStudy populationöncesinden farklı değildi p>0.05 . Tedavi ile hastaların %35'inde zorlu vital kapasite düzelmiş FVC >%10 artış , %31'inde azalmış ve %34'ünde değişmemişti. Sonuç: BDH ilişkili İAH tanı, tedavi ve takibi için yoğun çaba harcanmasına rağmen tedavide henüz tatmin edici noktaya ulaşılmamıştır. BDH ilişkili İAH hastaları için yeni kür sağlayıcı ajanlara ihtiyaç vardır

Anahtar Kelimeler

Bağ doku hastalıkları, İnterstitiel akciğer hastalığı, Yüksek rezolusyonlu akciğer tomografisi

Interstitial Lung Diseases in Rheumatology Practice: A Single Center Experience

Öz

Objective: Interstitial lung diseases ILDs are a heterogeneous group of pulmonary diseases affecting the pulmonary interstitium. ILDs may occur secondary to connective tissue diseases CTDs and increase morbidity and mortality due to ventilation impairment. The aim of this study was to reveal the clinical, laboratory and imaging features of CTD-related ILDs CTD-ILDs and to analyze the treatment approaches.Material and Methods: A total of 132 consecutive ILD patients were included in this cohort. Demographic characteristics, laboratory and high-resolution chest computed tomography HRCT results and treatments were analyzed.results: There were 99 patients with CTD-ILD, the mean age was 54.7±11.6 years, females made up 82.8%, median follow-up time was 48.5 months. There were 96 patients who were followed up for more than six months. The median number of HRCT scans was 3 with a median interval of 12.5 months. Most common HRCT findings were ground-glass opacities and interlobular septal thickening. One-third of all scans had a honeycomb pattern. 89.6% of CTD-ILD patients recieved corticosteroids, and 44.8% recieved antimalarials. Azathioprine and cyclophosphamide were the most commonly used immunosuppressive drugs. After treatment, the mean pulmonary function tests did not significantly differ from the baseline p >0.05 . 35% of the patients had improved forced vital capacity FVC >10% increase with treatment whereas 31% had decreased values and 34% were stable. conclusion: The desired point of the treatment of CTD-ILD patients has not been reached yet even though a significant effort is being made for the diagnosis, treatment and follow up. Novel curative agents are needed for patients with CTD-ILD

Anahtar Kelimeler

Connective tissue diseases, High-resolution computed tomography, Interstitial lung diseases

Kaynakça

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