Interstitial pneumonia with autoimmune features: monocentric prospective study

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Abstract

Aim. To study demographic, clinical, serological and morphological features of interstitial pneumonia with autoimmune features (IPAF), compare survival in IPAF and interstitial lung disease in connective tissue diseases (CTD-ILD), and identify predictors of mortality and transformation to CTD in the IPAF group.

Materials and methods. The IPAF group included 48 patients (75.0% women, median age 57.5 years), CTD-ILD – 49 patients (79.6% women, median age 60.0 years). The analysis of demographic, clinical, laboratory and instrumental data was performed, as well as comparison of survival with the Kaplan–Meier method and the log-rank test in the IPAF and CTD-ILD groups. In the IPAF group, predictors of mortality and the development of CTD were studied with multivariate regression analysis.

Results. Duration of observation period did not differ significantly in the IPAF and CTD-ILD groups (40.0 and 37.0 months, respectively). Clinical criteria of IPAF were observed in 25 (52.1%) patients, serological – in 44 (91.7%), morphological – in 44 (91.7%). Mortality in the IPAF group was significantly higher than in the CTD-ILD group (29.2 and 6.1%, respectively; p=0.023). The presence of diabetes mellitus, CT-pattern of usual interstitial pneumonia, and an initial low forced vital capacity value were independent predictors of mortality in the IPAF group. During the observation period, the development of CTD was noted in 4 (8.3%) patients with IPAF. The independent predictor of the CTD development was the increased C-reactive protein level.

Conclusion. IPAF is characterized by a lower survival rate compared to CTD-ILD, and a relatively low risk of CTD transformation.

About the authors

Larisa A. Akulkina

Sechenov First Moscow State Medical University (Sechenov University)

Email: akullar.ru@mail.ru
ORCID iD: 0000-0002-4307-8882

ассистент каф. внутренних, профессиональных болезней и ревматологии, врач-пульмонолог

Russian Federation, Moscow

Anastasia A. Shchepalina

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: akullar.ru@mail.ru
ORCID iD: 0000-0002-1826-0519

аспирант каф. внутренних, профессиональных болезней и ревматологии

Russian Federation, Moscow

Alexey S. Moiseev

Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University

Email: akullar.ru@mail.ru
ORCID iD: 0000-0002-5296-7622

врач-пульмонолог, аспирант каф. внутренних болезней

Russian Federation, Moscow; Moscow

Mikhail Yu. Brovko

Sechenov First Moscow State Medical University (Sechenov University)

Email: akullar.ru@mail.ru
ORCID iD: 0000-0003-0023-2701

канд. мед. наук, врач-пульмонолог, ассистент каф. внутренних, профессиональных болезней и ревматологии

Russian Federation, Moscow

Victoria I. Sholomova

Sechenov First Moscow State Medical University (Sechenov University)

Email: akullar.ru@mail.ru
ORCID iD: 0000-0002-8785-7968

канд. мед. наук, врач-пульмонолог, ассистент каф. внутренних, профессиональных болезней и ревматологии

Russian Federation, Moscow

Sergey V. Moiseev

Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University

Email: akullar.ru@mail.ru
ORCID iD: 0000-0002-7232-4640

д-р мед. наук, проф. каф. внутренних профессиональных болезней и ревматологии, проф. каф. внутренних болезней

Russian Federation, Moscow; Moscow

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2. Fig. 1. Incidence of clinical signs of interstitial pneumonia with autoimmune features.

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3. Fig. 2. Incidence of serological signs of interstitial pneumonia with autoimmune features.

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4. Fig. 3. Survival dependence of patients in interstitial pneumonia groups with autoimmune signs and systemic connective tissue disease-interstitial lung disease.

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