Clinical Features and Outcome of Acute Exacerbation of Interstitial Pneumonia: Collagen Vascular Diseases-Related versus Idiopathic

Background: Relatively little is known about acute exacerbation (AE) of interstitial pneumonia associated with collagen vascular diseases (CVD-IPs). Objectives: This study was aimed at clarifying clinical characteristics and outcome in AE of CVD-IPs, compared with those of idiopathic interstitial pneumonias (IIPs). Methods: We retrospectively reviewed 112 admission cases with suspected AE of CVD-IPs or IIPs during 2003–2009. IIPs were diagnosed with idiopathic pulmonary fibrosis (IPF) or non-IPF, mostly based on radiologic findings. Of these, 15 AEs of CVD-IPs (6 rheumatoid arthritis, 6 dermatomyositis and 3 systemic sclerosis) and 47 AEs of IIPs (13 IPF and 34 non-IPF) were included. Results: The clinical characteristics in AE of CVD-IPs were similar to those of IIPs, except for younger age (63.3 8 6.8 vs. 73.8 8 9.1 years; p = 0.0001) and higher PaO 2 /FiO 2 at the onset of AE (205 8 81.2 vs. 145 8 53.8 mm Hg; p = 0.002) in the former. Dermatomyositis-related interstitial pneumonia (IP) showed a relatively indolent onset and was often associated with worsening control of the underlying disease, whereas AE of other CVDReceived: January 13, 2011 Accepted after revision: June 7, 2011 Published online: September 6, 2011 Ryo Tachikawa, MD Department of Respiratory Medicine, Kobe City Medical Center General Hospital 4-6 Minatojima-nakamachi Chuo-ku, Kobe 650-0046 (Japan) Tel. +81 78 302 4321, E-Mail ryotkw @ kcho.jp © 2011 S. Karger AG, Basel 0025–7931/12/0831–0020$38.00/0 Accessible online at: www.karger.com/res For editorial comment see p. 13 D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /1 9/ 20 17 3 :1 2: 16 P M