PhD Scientific Days 2021

CL_III_L: Clinical Medicine III. Lectures

Connective tissue disease-associated interstitial lung disease (CTD-ILD) patient characteristics and treatment possibilities.

Tamás Nagy1, Alexandra Nagy1, Noémi Eszes1, Anikó Bohács1,
Erik Palmer1, Enikő Bárczi1, Abigél Kolonics-Farkas1, Ádám Tárnoki2, Dávid Tárnoki2, Kinga Karlinger2, Veronika Müller1, Krisztina Vincze1
Semmelweis University, Department of Pulmonology, Budapest1
Semmelweis University, Medical Imaging Centre, Budapest2

Text of the abstract

Introduction: Connective tissue disease (CTD) is a group include systemic diseases with clinically diverse manifestations. Lung involvement is common and the outcome is mainly determined by the development of interstitial lung disease (ILD).
Aim: Our aim was to evaluate patient characteristics, treatment possibilities and high resolution CT (HRCT) patterns among patients presented in ILD-team at the Department of Pulmonology Semmelweis University.
Methods: In our retrospective study between January 2017 and July 2019 the ILD-team discussed 512 patients and CTD-ILD was diagnosed in 55 cases. Detailed respiratory history and pulmonary examinations were performed, including chest x-ray, lung function and diffusion measurement, blood gas analysis, 6 minutes walk test and lab tests. In all patients ILD was verified with HRCT.
Results: Average age of our patients was 61,38±13,48 years, with significantly more women (N=42) systemic sclerosis (SSc) and rheumatoid arthritis (RA) were the most frequent diseases. According to HRCT patterns patients were cathegorised into 3 groups: 1. nonspecific interstitial pneumonia (NSIP) N=37 (62.2%); 2. possible usual interstitial pneumonia (pUIP) N=8 (14.5%); 3. Usual interstitial pneumonia (UIP) N=10 (18.1%). Diffusion parameters for Carbon Monoxide (TLCO=50±18,21%) showed significantly decreased values in the UIP group (p=0,021) as compared to the other radiology patterns. Steroids were most commonly used as immunosuppressive medications in CTD-ILD patients (NSIP=51%, pUIP=50% and UIP=80%). The two most frequent commorbidities were hypertension (38%) and gastroesophageal reflux disease (20%).
Conclusion: In CTD-ILD patients RA and SSc were, mostly associated with NSIP pattern. UIP was associated with more severe functional impairment.The heterogeneity of the diseases require personalized treatment including immunosuppressive and antifibrotic drugs.
Funding: EFOP-3.6.3-VEKOP-16-2017-00009 - Kiegészítő Kutatási Kiválósági Ösztöndíj

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine