PARAMETERS AFFECTING DIAGNOSTIC AND TREATMENT APPROACH IN IDIOPATHIC INTERSTITIAL PNEUMONIAS

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PARAMETERS AFFECTING DIAGNOSTIC AND TREATMENT
APPROACH IN IDIOPATHIC INTERSTITIAL PNEUMONIAS

• LEYLA YILMAZ AYDIN, AYDIN YILMAZ, YURDANUR
  ERDOGAN, ÇIGDEM BIBER, ÜLKÜ YILMAZ TURAY, PINAR
  ERGÜN, EZGI SIMSEK

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AIM

• To investigate the clinical, radiological and
  laboratory features those affect the diagnostic
  and treatment approaches of patients who
  diagnosed as idiopathic interstitial pneumonia
  (IIP) according to 2002 ATS/ERS consensus

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METHOD

• Records of 57 patients who admitted to 7th clinic
  of Ataturk Chest Disease and Thoracic Surgery
  Research and Education Hospital between 2002-2009
  and diagnosed as certain IIP either clinically/
  radiologically or pathologically evaluated
  retrospectively.

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RESULTS

• 54.4 men, 45.6 women
• Mean age 61.3111.99
• Dyspnea (89.5) and cough(75.4) 
• 45.6 never smoked
• Mean cigarette 35.5525.4 package/year
• 42.1 asbestos, 35.1 biomass
• Inspiratory rales 77.2
• 63.2 honeycomb in HRCT

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RESULTS

• 31(54.4) patients had undergone transbronchial
  biopsy
• It was diagnostic in 5(8.8) patients
• 15(26.3) patients had undergone thoracotomy and
  all of them were diagnostic
• No patient had undergone BAL, transthorasic
  biopsy and WATS

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RESULTS

• 75.5 of the patients were IPF 63.2 (36)
  clinically and radiologically diagnosed, 12.3
  (7) had pathological pattern of usual
  interstitial pneumonia (UIP)
• 3.5(2) desquamative  interstitial pneumonia
  (DIP)
• 1.8(1) acute interstitial pneumonia (AIP)
• 5.3(3) nonspecific interstitial pneumonia (NIP)
• 3.5(2) respiratory bronchiolitis -interstitial
  lung disease (RBILD)
• 10.5(6) criptogenic organising pneumonia (COP)

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PARAMETERS AFFECTING DIAGNOSTIC APPROACH

• Age (68-53)(plt0,05) (pathological diagnose is
  common)
• Fever (plt0,05) (pathological diagnose is common)
• Cigarette, asbestos, biomass (pgt0,05)
• Rales, clubbing and cyanosis (plt0,05)
  (clinical/radiological diagnose is common)
• Honeycomb (plt0,05) (clinical/radiological
  diagnose is common)

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PARAMETERS EFFECTING DIAGNOSTIC APPROACH

• DLCO median54-73
• DLCO/VA median71-91
• pCO2 median36-33
• Htc median42-40

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PARAMETERS AFFECTING TREATMENT APPROACH

• Age median70,5-59,5
• Chest pain
• FEV1/FVC median90-85
• DLCO median56-56,5
• DLCO/VA median78-83

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CONCLUSION

• Most important parameters that affects the
  diagnostic and treatment approach are age, lung
  function parameters and pCO2.