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Search Results: 1 - 10 of 1206 matches for " Idiopathic Interstitial Pneumonias "
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Idiopathic Interstitial Pneumonias (IIPs): Review of Clinical, Radiographic and High-Resolution Computed Tomography (HRCT)  [PDF]
Zoheb Gulab Shaikh, Cheng Li, Yiming Li
Advances in Computed Tomography (ACT) , 2016, DOI: 10.4236/act.2016.52002
Abstract: Making a confident diagnosis is a complex task for a specific form of interstitial lung disease and providing appropriate management in an attempt to achieve normalization of the disease can put up an alarming process for the clinicians. A set of diffuse and restrictive lung diseases incorporate with idiopathic interstitial pneumonias, showing inflammation and fibrosis of the interstitium due to parenchymal damage. High-resolution computed tomography (HRCT) has magnified the diagnostic standpoint in stepwise identification and classified various patterns in the evaluation of interstitial lung disease. The aim of our review is to elaborate clinical, radiographic and typical and atypical HRCT findings of idiopathic interstitial pneumonias by correlating with its differential diagnosis. Idiopathic pulmonary fibrosis is the most predominant idiopathic interstitial pneumonias and its diagnosis needs to omit all other well-known causes of interstitial lung diseases. According to the 2011 evidence-based guidelines, usual interstitial pneumonia can be diagnosed by HRCT when all criteria are fulfilled. Non-specific interstitial pneumonia is distinguished by bilateral patchy ground-glass opacities and irregular linear/reticular opacities. Respiratory bronchiolitis associated-interstitial lung disease and desquamative interstitial pneumonia show centrolobular nodules and ground-glass opacities as imaging patterns. Cryptogenic organizing pneumonia consists of patchy peripheral or peribronchial consolidations, while ground-glass opacities with tendency for migration, which is evolving to fibrosis, in acute interstitial pneumonia. Lymphoid interstitial pneumonia and idiopathic pleuro-parenchymal fibroelastosis are classified under rare idiopathic interstitial pneumonias. HRCT images help radiologists in diagnosis and mapping specific patterns of idiopathic interstitial pneumonias. This article reviews the stages of evolution in HRCT features for idiopathic interstitial pneumonias.
Pneumonias intersticiais idiopáticas: Uma revis?o da literatura
Mota,Paulo José de Lima;
Revista Portuguesa de Pneumologia , 2006,
Abstract: interstitial idiopathic pneumonias are a group of diseases whose rarity and variety of clinical, radiological and pathological descriptions creates difficulties in study and management. an example of this is the classification method for this group, with only 2002 seeing some consensus. the aim of this article is to review the main literature to contribute to an understanding of this subject.
Idiopathic interstitial pneumonias: Classification revision
Demosthenes Bouros MD, PhD, FCCP
Pneumon , 2010,
Abstract: The American Thoracic Society (ATS), the European Respiratory Society (ERS) and the Japan Respiratory Society (JRS) are planning a revision of the 2002 ATS/ERS International Multidisciplinary Classification of Idiopathic Interstitial Pneumonias (IIPs)1. In two years’ time it will be 10 years since its publication and with a view to publishing the revision after 10 years (i.e., in 2012), a steering committee has been established, which met in New Orleans during ATS congress in May 2010 and more recently in Barcelona during the ERS congress (Photo). The committee will meet again during the ATS and the ERS congresses that will be held in the next two years, with an additional meeting in Modena, Italy, in Αpril 2011.
Lymphatic fluctuation in the parenchymal remodeling stage of acute interstitial pneumonia, organizing pneumonia, nonspecific interstitial pneumonia and idiopathic pulmonary fibrosis
Parra, E.R.;Araujo, C.A.L.;Lombardi, J.G.;Ab’Saber, A.M.;Carvalho, C.R.R.;Kairalla, R.A.;Capelozzi, V.L.;
Brazilian Journal of Medical and Biological Research , 2012, DOI: 10.1590/S0100-879X2012007500066
Abstract: because the superficial lymphatics in the lungs are distributed in the subpleural, interlobular and peribroncovascular interstitium, lymphatic impairment may occur in the lungs of patients with idiopathic interstitial pneumonias (iips) and increase their severity. we investigated the distribution of lymphatics in different remodeling stages of iips by immunohistochemistry using the d2-40 antibody. pulmonary tissue was obtained from 69 patients with acute interstitial pneumonia/diffuse alveolar damage (aip/dad, n = 24), cryptogenic organizing pneumonia/organizing pneumonia (cop/op, n = 6), nonspecific interstitial pneumonia (nsip/nsip, n = 20), and idiopathic pulmonary fibrosis/usual interstitial pneumonia (ipf/uip, n = 19). d2-40+ lymphatic in the lesions was quantitatively determined and associated with remodeling stage score. we observed an increase in the d2-40+ percent from dad (6.66 ± 1.11) to uip (23.45 ± 5.24, p = 0.008) with the advanced process of remodeling stage of the lesions. kaplan-meier survival curves showed a better survival for patients with higher lymphatic d2-40+ expression than 9.3%. lymphatic impairment occurs in the lungs of iips and its severity increases according to remodeling stage. the results suggest that disruption of the superficial lymphatics may impair alveolar clearance, delay organ repair and cause severe disease progress mainly in patients with aip/dad. therefore, lymphatic distribution may serve as a surrogate marker for the identification of patients at greatest risk for death due to iips.
Systemic sclerosis and idiopathic interstitial pneumonia: histomorphometric differences in lung biopsies
Parra, Edwin Roger;Otani, Leandro Hideki;Carvalho, Erika Franco de;Ab'Saber, Alexandre;Capelozzi, Vera Luiza;
Jornal Brasileiro de Pneumologia , 2009, DOI: 10.1590/S1806-37132009000600006
Abstract: objective: the aim of this study was to examine the parenchymal and extracellular matrix remodeling process in two histologic patterns-nonspecific interstitial pneumonia (nsip) and usual interstitial pneumonia (uip)-in cases of idiopathic and sclerosis/systemic sclerosis (ssc)-associated interstitial pneumonia. methods: we examined 15 cases of idiopathic nsip, 10 cases of idiopathic uip, 5 cases of ssc-uip and 9 cases of ssc-nsip. in the lung parenchyma, epithelial cells, endothelial cells and myofibroblasts were evaluated by immunohistochemical staining, whereas histochemical staining was used in order to evaluate collagen/elastic fibers in the extracellular matrix. results: the percentage of surfactant protein a-positive epithelial cells was significantly greater in idiopathic nsip than in ssc-nsip, as well as being greater in idiopathic uip than in ssc-uip. idiopathic nsip and idiopathic uip presented significantly higher immunoexpression of alpha smooth muscle actin in myofibroblasts than did ssc-nsip and ssc-uip. the percentage of cd34 endothelial cells in the pulmonary microvasculature was significant lower in idiopathic uip than in ssc-uip. the density of collagen fibers was significantly greater in idiopathic nsip and idiopathic uip than in ssc-nsip and uip. in contrast, the elastic fiber density was significantly lower in idiopathic uip than in ssc-uip. conclusions: increased collagen synthesis, destruction of elastic fibers, high myofibroblast proliferation and poor microvascularization might represent a remodeling process found in idiopathic interstitial pneumonia, whereas the reverse might represent a repair process in ssc-associated interstitial pneumonia.
The benefits of exercise training in interstitial lung disease: protocol for a multicentre randomised controlled trial
Leona Dowman, Christine F McDonald, Catherine Hill, Annemarie Lee, Kathryn Barker, Claire Boote, Ian Glaspole, Nicole Goh, Annemarie Southcott, Angela Burge, Rebecca Ndongo, Alicia Martin, Anne E Holland
BMC Pulmonary Medicine , 2013, DOI: 10.1186/1471-2466-13-8
Abstract: One hundred and sixteen participants with interstitial lung disease recruited from three tertiary institutions will be randomised to either an exercise training group (supervised exercise training twice weekly for eight weeks) or a usual care group (weekly telephone support). The 6-minute walk distance, peripheral muscle strength, health-related quality of life, dyspnoea, anxiety and depression will be measured by a blinded assessor at baseline, immediately following the intervention and at six months following the intervention. The primary outcome will be change in 6-minute walk distance following the intervention, with planned subgroup analyses for participants with idiopathic pulmonary fibrosis, dust-related interstitial lung disease and connective-tissue related interstitial lung disease. The effects of disease severity on outcomes will be evaluated using important markers of disease severity and survival, such as forced vital capacity, carbon monoxide transfer factor and pulmonary hypertension.This trial will provide certainty regarding the role of exercise training in interstitial lung disease and will identify at what time point within the disease process this treatment is most effective. The results from this study will inform and optimise the clinical management of people with interstitial lung disease.Australian New Zealand Clinical Trials Registry ACTRN12611000416998The interstitial lung diseases (ILDs) are a disabling and diverse group of chronic lung conditions that have been broadly classified into four groups: ILD of known cause such as occupational or environmental exposures and/or collagen vascular disease; granulomatous ILD such as sarcoidosis; idiopathic interstitial pneumonias including idiopathic pulmonary fibrosis (IPF) and nonspecific interstitial pneumonia (NSIP); and other rare forms of ILD including lymphangioleiomyomatosis, pulmonary Langerhans’ cell histiocytosis/histiocytosis X, and eosinophilic pneumonia [1]. Many ILDs are characterised
Effects of red cell distribution width on prognosis of inpatients with idiopathic interstitial pneumonias

ZOU Xiao
, NI Ying-meng, CHEN Wei

- , 2015, DOI: 11.3969/j.issn.1674-8115.2015.08.019
Abstract: 目的 探讨红细胞分布宽度(RDW)与特发性间质性肺炎(IIPs)预后的相关性。方法 经诊断明确的IIPs患者61例,以死亡/生存作为观察终点对患者进行分组,记录两组患者的临床资料,分析IIPs的危险因素,探讨RDW与IIPs预后的相关性。结果 61例患者男33例,女28例,男女比例为1.2∶1,平均年龄(64.60±16.33)岁,死亡组35例,生存组26例。与生存组相比,死亡组平均年龄更高(P=0.004)、出现呼吸衰竭更明显(P=0.002)。所有患者的RDW基线值为(15.12±1.71)%,RDW末次值为(16.30±2.54)%。死亡组RDW基线值和末次值分别为(15.95±1.50)%和(17.84±2.26)%,均明显高于生存组(P=0.000)。Logistic多变量分析显示,在控制性别及年龄因素的基础上,RDW是IIPs预后的独立预测因素。RDW判断IIPs预后的界值为15.70%,受试者工作特征曲线(ROC曲线)下面积为0.94(95%CI:1.61~1.95),判断IIPs预后的敏感度为88.60%,特异度为96.20%;RDW≥15.70%组死亡率明显高于RDW<15.70%组(P=0.000)。结论 RDW与IIPs病变的严重程度独立相关,是IIPs预后的独立预测因素。
: Objective To explore the correlation between red cell distribution width (RDW) and prognosis of idiopathic interstitial pneumonias (IIPs). Methods A total of 61 patients with confirmed diagnosis of IIPs were divided into the survival group and death group by using death/survival as end point of observation. Their clinical data were recorded. The risk factors of IIPs were analyzed and the correlation between RDW and prognosis of IIPs was explored. Results Among 61 patients, 33 were males and 28 were females, the ratio of male and female was 1.2∶1, and the average age was 64.60±16.33. Compared with the survival group (n=26), the average age of death group (n=35) was higher (P=0.004) and respiratory failure was severer (P=0.002). The baseline value of RDW of all patients was (15.12±1.71)% and last value of RDW was (16.30±2.54)%. The baseline value and last value of RDW of the death group were (15.95 ± 1.50)% and (17.84±2.26)% and significantly higher than those of the survival group (P=0.000). Logistic multivariate analysis showed that RDW was an independent factor for predicting the prognosis of IIPs based on gender and age being controlled. The threshold value for predicting the prognosis of IIPs by RDW was 15.70% and the area under receiver operating characteristic (ROC) curve was 0.94 (95%CI 1.61-1.95) with the sensitivity of 88.60% and specificity of 96.20%. The mortality of patients with RDW≥ 15.70% was significantly higher than that of patients with RDW<15.70% (P=0.000). Conclusion RDW independently correlates with severity of IIPs and is an independent factor for predicting the prognosis of IIPs
Risk Factors for Postoperative Acute Exacerbation of Idiopathic Interstitial Pneumonia Following Surgery for Primary Lung Cancer  [PDF]
Toru Tanaka, Shinji Abe, Hiroki Hayashi, Koichiro Kamio, Yoshinobu Saito, Jiro Usuki, Arata Azuma, Iwao Mikami, Shuji Haraguchi, Kiyoshi Koizumi, Jitsuo Usuda, Akihiko Gemma
Open Journal of Respiratory Diseases (OJRD) , 2014, DOI: 10.4236/ojrd.2014.42008
Objective: Postoperative acute exacerbation of idiopathic interstitial pneumonia (IIP) is a serious complication in patients with lung cancer. This study was aimed to investigate risk factors for postoperative acute exacerbation of IIP in surgery for primary lung cancer. Method: We evaluated retrospectively 37 IIP patients combined with primary lung cancer who underwent lung resection for lung cancer from January 2006 and March 2010. Preoperative and perioperative clinical data were collected and analyzed. Results: Ten of 37 patients (27.0%) developed acute exacerbation of IIP after surgery for primary lung cancer and five patients (13.5%) died of progressive respiratory failure. There was no significant difference in preoperative clinical factors between acute exacerbation (AE) group and non-acute exacerbation (non-AE) group. In perioperative factors, the duration of anesthesia is significantly longer in AE group than in non-AE group. Conclusion: These data suggest that it is unable to predict postoperative acute exacerbation of IIP from preoperative clinical data. Perioperative and postoperative management might be important to prevent acute exacerbation of IIP combined lung cancer.
The Expression of Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases in Idiopathic Interstitisal Pneumonia  [PDF]
Ji Young Shin, Yu Jin Kim, Sun Young Kyung, Seung Yeon Ha, Sung Hwan Jeong
Open Journal of Respiratory Diseases (OJRD) , 2014, DOI: 10.4236/ojrd.2014.43014
Background: Idiopathic interstitial pneumonia is characterized by fibroblast proliferation and extracellular matrix (ECM) accumulation. Matrix metalloproteases (MMPs) and tissue inhibitors of metalloproteases (TIMPs) have been shown to regulate remodeling of the ECM, which indicates that they are important factors in the process of lung fibrosis. Therefore, we evaluated the expression of MMPs and TIMPs in tissues obtained from patients with idiopathic interstitial pneumonia and control tissues. Methods: Thirty-seven patients who were diagnosed with IIP (22: IPF, 13: NSIP, 2: COP) and 5 controls were enrolled in this study. The MMP-2 and -9 activity in lung tissue obtained from these patients was analyzed using gelatin zymography and the levels of TIMP-1 and -2 were measured by western blotting. We also evaluated the expression of MMP-2 and -9, as well as that of TIMP-1 and -2 in lung tissue using immunohistochemistry. Results: The levels of MMP-2 and MMP-9 were significantly increased in patients with IPF compared to those with NSIP and COP. The activities of TIMP-1 and -2 were also higher in patients with IPF than NSIP/COP patients and control subjects. There were no significant differences observed in the activities of MMPs and TIMPs obtained from patients with NSIP/COP and control subjects. The immunohistochemical analysis showed that TIMP-2 and MMP-2 were strongly stained at the fibroblasts of the fibroblastic foci in patients with IPF. Conclusions: These results suggest that over-expression of gelatinases and TIMPs in patients with IPF are important factors in the irreversible fibrosis that is associated with lung parenchyma.
The classification, natural history and radiological/histological appearance of idiopathic pulmonary fibrosis and the other idiopathic interstitial pneumonias
G. Raghu,A. G. Nicholson,D. Lynch
European Respiratory Review , 2008,
Abstract: The idiopathic interstitial pneumonias (IIPs) are a heterogeneous group of rare interstitial lung diseases (ILDs) or diffuse parenchymal lung diseases, which, as their name implies, are of unknown aetiology. The past 10 yrs have seen important advances in the classification of the IIPs into idiopathic pulmonary fibrosis (IPF) and its corresponding histopathological pattern of usual interstitial pneumonia (UIP), plus six non-IPF IIP subtypes. The present article will look at the current classification of IIPs, arising from the Consensus Statement of the American Thoracic Society and European Respiratory Society, and discusses the importance of differential diagnosis of IPF from the non-IPF IIP subtypes, especially nonspecific interstitial pneumonia. Diagnosis of IIPs is a dynamic process involving close collaboration between pulmonologists, radiologists and pathologists. Increasingly accurate diagnosis of IPF has been made possible by the use of high-resolution computed tomography (HRCT) and refinements in surgical lung biopsy. In IPF, a lung HRCT will typically reveal irregular reticular opacities, traction bronchiestasis and, most importantly, peripheral honeycombing. In contrast, histological examination shows evidence of UIP manifesting as typically subpleural and paraseptal established fibrosis, often with honeycomb changes, associated with mild chronic inflammation and varying numbers of fibroblastic foci in continuity with the edges of areas of established fibrosis. Despite these advances, obtaining a consistent and uniform diagnosis of idiopathic interstitial pneumonias is difficult, with studies showing significant disagreement in the diagnosis of interstitial lung diseases between academic centres of expertise and community-based clinicians. Greater interaction between academic and community clinicians, together with improved education, is needed to bridge this gap.
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