Prognostic value of radiological findings indeterminate for UIP pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with MPO-ANCA
Abstract Background Myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) is often positive in patients with interstitial lung disease (ILD), which is also often present in patients with microscopic polyangiitis (MPA). A possible association between MPO-ANCA, MPA, and idiopathic ILD remains...
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2021
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oai:doaj.org-article:11254bfc4cc64655b49ecbe56dbb97bd2021-11-08T11:13:23ZPrognostic value of radiological findings indeterminate for UIP pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with MPO-ANCA10.1186/s12890-021-01718-w1471-2466https://doaj.org/article/11254bfc4cc64655b49ecbe56dbb97bd2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12890-021-01718-whttps://doaj.org/toc/1471-2466Abstract Background Myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) is often positive in patients with interstitial lung disease (ILD), which is also often present in patients with microscopic polyangiitis (MPA). A possible association between MPO-ANCA, MPA, and idiopathic ILD remains unclear. The objective of this study was to determine whether high-resolution computed tomography (HRCT) classification based on recent idiopathic pulmonary fibrosis guideline and specific CT findings can obtain new knowledge of prognostic factors in all MPO-ANCA-positive patients with ILD including both idiopathic ILD and MPA-ILD. Methods We analyzed 101 consecutive MPO-ANCA-positive patients with respiratory disease. We assessed the diagnostic accuracy of CT findings, HRCT pattern, and specific radiological signs. Prognostic predictors were determined using Cox regression models. Results Subjects with chronic ILD included 22 patients with MPA-ILD and 39 patients with ILD but without MPA. A quarter of the patients were radiological indeterminate for usual interstitial pneumonia (UIP) pattern, which resulted in a better prognosis than that for UIP pattern. “Increased attenuation around honeycomb and traction bronchiectasis” and “anterior upper lobe honeycomb-like lesion” were found to be highly frequent radiological findings (39% and 30%, respectively). In addition, the latter finding was a significant negative prognostic factor. Conclusions Radiological indeterminate for UIP was a useful HRCT classification in MPO-ANCA-positive patients with ILD. In addition, anterior upper lobe honeycomb-like lesion was found to be specific radiological finding that was a significant prognostic factor. The present results might aid in the assessment of appropriate strategies of diagnosis in these patients.Hideaki YamakawaShintaro SatoTomohiko NakamuraTomotaka NishizawaRie KawabeTomohiro ObaMasanobu HorikoshiKeiichi AkasakaMasako AmanoKazuyoshi KuwanoHiroki SasakiHidekazu MatsushimaBMCarticleAnterior upper lobe honeycomb-like lesionIndeterminate for usual interstitial pneumoniaInterstitial lung diseaseMicroscopic polyangiitisDiseases of the respiratory systemRC705-779ENBMC Pulmonary Medicine, Vol 21, Iss 1, Pp 1-10 (2021) |
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DOAJ |
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EN |
| topic |
Anterior upper lobe honeycomb-like lesion Indeterminate for usual interstitial pneumonia Interstitial lung disease Microscopic polyangiitis Diseases of the respiratory system RC705-779 |
| spellingShingle |
Anterior upper lobe honeycomb-like lesion Indeterminate for usual interstitial pneumonia Interstitial lung disease Microscopic polyangiitis Diseases of the respiratory system RC705-779 Hideaki Yamakawa Shintaro Sato Tomohiko Nakamura Tomotaka Nishizawa Rie Kawabe Tomohiro Oba Masanobu Horikoshi Keiichi Akasaka Masako Amano Kazuyoshi Kuwano Hiroki Sasaki Hidekazu Matsushima Prognostic value of radiological findings indeterminate for UIP pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with MPO-ANCA |
| description |
Abstract Background Myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) is often positive in patients with interstitial lung disease (ILD), which is also often present in patients with microscopic polyangiitis (MPA). A possible association between MPO-ANCA, MPA, and idiopathic ILD remains unclear. The objective of this study was to determine whether high-resolution computed tomography (HRCT) classification based on recent idiopathic pulmonary fibrosis guideline and specific CT findings can obtain new knowledge of prognostic factors in all MPO-ANCA-positive patients with ILD including both idiopathic ILD and MPA-ILD. Methods We analyzed 101 consecutive MPO-ANCA-positive patients with respiratory disease. We assessed the diagnostic accuracy of CT findings, HRCT pattern, and specific radiological signs. Prognostic predictors were determined using Cox regression models. Results Subjects with chronic ILD included 22 patients with MPA-ILD and 39 patients with ILD but without MPA. A quarter of the patients were radiological indeterminate for usual interstitial pneumonia (UIP) pattern, which resulted in a better prognosis than that for UIP pattern. “Increased attenuation around honeycomb and traction bronchiectasis” and “anterior upper lobe honeycomb-like lesion” were found to be highly frequent radiological findings (39% and 30%, respectively). In addition, the latter finding was a significant negative prognostic factor. Conclusions Radiological indeterminate for UIP was a useful HRCT classification in MPO-ANCA-positive patients with ILD. In addition, anterior upper lobe honeycomb-like lesion was found to be specific radiological finding that was a significant prognostic factor. The present results might aid in the assessment of appropriate strategies of diagnosis in these patients. |
| format |
article |
| author |
Hideaki Yamakawa Shintaro Sato Tomohiko Nakamura Tomotaka Nishizawa Rie Kawabe Tomohiro Oba Masanobu Horikoshi Keiichi Akasaka Masako Amano Kazuyoshi Kuwano Hiroki Sasaki Hidekazu Matsushima |
| author_facet |
Hideaki Yamakawa Shintaro Sato Tomohiko Nakamura Tomotaka Nishizawa Rie Kawabe Tomohiro Oba Masanobu Horikoshi Keiichi Akasaka Masako Amano Kazuyoshi Kuwano Hiroki Sasaki Hidekazu Matsushima |
| author_sort |
Hideaki Yamakawa |
| title |
Prognostic value of radiological findings indeterminate for UIP pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with MPO-ANCA |
| title_short |
Prognostic value of radiological findings indeterminate for UIP pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with MPO-ANCA |
| title_full |
Prognostic value of radiological findings indeterminate for UIP pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with MPO-ANCA |
| title_fullStr |
Prognostic value of radiological findings indeterminate for UIP pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with MPO-ANCA |
| title_full_unstemmed |
Prognostic value of radiological findings indeterminate for UIP pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with MPO-ANCA |
| title_sort |
prognostic value of radiological findings indeterminate for uip pattern and anterior upper lobe honeycomb-like lesion in chronic fibrosing interstitial lung disease associated with mpo-anca |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/11254bfc4cc64655b49ecbe56dbb97bd |
| work_keys_str_mv |
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