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Romatoloji Pratiğinde İnterstitiel Akciğer Hastalığı: Tek Merkez Deneyimi

Interstitial Lung Diseases in Rheumatology Practice: A Single Center Experience

Journal Name:

Publication Year:

DOI: 
10.17954/amj.2017.79
Abstract (2. Language): 
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 (1-10) 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.
Abstract (Original Language): 
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(1-10) 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 öncesinden 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.
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