Significance of Combined Emphysema in Idiopathic Pulmonary Fibrosis and Serum Surfactant Protein-D as a Prognostic Factor
Journal Title: Pulmonary Research and Respiratory Medicine – Open Journal - Year 2017, Vol 4, Issue 2
Abstract
Background and Objectives Idiopathic pulmonary fibrosis (IPF) is a chronic disease of unknown aetiology and is often associated with a syndrome called combined pulmonary fibrosis and emphysema (CPFE). This study aimed to identify practical predictors of prognosis in IPF patients associated with CPFE. Subjects and Methods We retrospectively studied 72 patients with IPF and evaluated the threshold of emphysematous area affecting prognosis on high-resolution computed tomography (HRCT) scans. As predictor candidates, various pulmonary function tests (PFTs) and biomarkers, e.g. surfactant protein (SP)-A and SP-D, were assessed. Results The survival rate of the CPFE group, defined as having an emphysematous area greater than 25% on HRCT, was significantly worse than that of the non-CPFE group, despite no significant difference in fibrosis scores. An annual percent decline of diffusing capacity of the lung for carbon monoxide (% DLCO) of more than 5% was a significant prognostic factor in the CPFE group. High concentration of serum SP-D was a significant prognostic factor in both the CPFE and non-CPFE groups. However, cut-off levels in the CPFE group were lower than those in the non-CPFE group. Conclusions We demonstrated worse prognosis in IPF associated with CPFE syndrome compared to the other subset of IPF, and showed that % DLCO and SP-D are useful predictors of poor prognosis.
Authors and Affiliations
Masanori Shiratori
Keywords
Related Articles
- EP ID EP546159
- DOI 10.17140/PRRMOJ-4-135
- Views 207
- Downloads 0
Pulmonary Aspergillosis Mimicking Primary Lung Cancer
A 68-year-old man was transferred to our hospital because of abnormal lung nodule. He was a social drinker and a current smoker with a history of 70 pack-years. He had no symptoms and was a good nutritional status. Based...
Flapping Tremor as a Diagnostic Tool for Evaluation of Hypercapnia
A 76 year-old woman was admitted to our hospital because of aspiration pneumonia. Four days after initiation of the antibiotic treatment, her respiratory status became to be better; however, hypoxemia was recurred with t...
Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis: How Best is CBNAAT when Compared to Conventional Methods of TB Detection?
Background Globally, India is a home for more than 25% of global Tuberculosis (TB) burden. The sensitivity of smear microscopy and its inability to detect drug resistance limits its impact on TB control. We compared the...
Cultural Differences in Illness Perception and Adherence to Treatment of Cystic Fibrosis Patients
Background: Patients with Cystic Fibrosis (CF) have a complex treatment regimen which poses emotional, social and economic burden. Adherence to treatment may be influenced by the patient’s own beliefs about the disease,...
Tuberculosis in Pregnancy: Delayed Diagnosis, Lost Lives
Tuberculosis still remains an important global health disease, killing many people annually. Yet it is a preventable cause of death. Maternal mortality rates due to tuberculosis and HIV/AIDS in Sub-Saharan Africa make up...