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自身免疫性间质性肺病在拉丁美洲。

Autoimmune interstitial lung disease in Latin-America.

机构信息

Autoimmune Diseases Unit, Hospital Privado de Comunidad, Mar del Plata, Argentina..

Respiratory Medicine, Hospital Privado de Comunidad, Mar del Plata, Argentina.

出版信息

Clin Immunol. 2019 Feb;199:52-56. doi: 10.1016/j.clim.2018.12.013. Epub 2018 Dec 10.

Abstract

Information about the prognosis and natural history of autoimmune interstitial lung diseases (Ai-ILD) is limited. The aim of the study was to evaluate the characteristics of patients diagnosed with Ai-ILD in Latin-America. We conducted an ambispective multicenter cohort study in 25 centers of Argentina, Colombia, and Uruguay between January 2015 and April 2018. Participants were included in the study if they had diagnosis of Ai-ILD performed by a multidisciplinary team. Patients were classified into the following sub-groups: connective tissue disease-associated ILD (ILD-CTD), interstitial pneumonia with autoimmune features (IPAF), and positive antineutrophils cytoplasmatic antibodies associated ILD (ILD-ANCA). All images were reviewed by a blinded thoracic radiologist. Out of the 381 patients included during the study period, 282 (74%; 95% CI; 69.39-78.16) were women. Mean age was 58 years old (SD 16). Three-hundred and twenty-five (85.1%; 95% CI 81.39-88.5) patients were classified as ILD-CTD (rheumatoid arthritis 31%, systemic sclerosis 29%, dermatomyositis 15%). Thirty-six patients were classified as IPAF (9.5%; 95% CI 6.9-12.8), and 13 (3.5%; 95% CI 2-5.75) as ILD-ANCA. Fifty percent of patients (95% CI 45.12-55.43) had a mild decrease of the forced vital capacity at the time of diagnosis. The most common treatment strategy was the combination of steroids and cyclophosphamide (30.1%; 95% CI 25.32-35.34) followed by azathioprine (20,3%; 95% CI 16.32-25.14). In conclusion, to the best of our knowledge, this is the first study to evaluate the characteristics and treatment strategies used in patients affected by Ai-ILD in Latin-America. Future studies should to evaluate the prognosis and impact of current treatment strategies in patients with Ai-ILD.

摘要

自身免疫性间质性肺病(Ai-ILD)的预后和自然病史信息有限。本研究旨在评估拉丁美洲诊断为 Ai-ILD 患者的特征。我们在 2015 年 1 月至 2018 年 4 月期间在阿根廷、哥伦比亚和乌拉圭的 25 个中心进行了一项前瞻性、多中心队列研究。如果多学科团队做出 Ai-ILD 诊断,则将患者纳入研究。患者分为以下亚组:结缔组织病相关间质性肺病(ILD-CTD)、自身免疫特征性间质性肺炎(IPAF)和阳性抗中性粒细胞胞浆抗体相关间质性肺病(ILD-ANCA)。所有图像均由一名盲法胸部放射科医生进行审查。在研究期间,共有 381 名患者纳入研究,其中 282 名(74%;95%CI;69.39-78.16)为女性。平均年龄为 58 岁(标准差 16)。325 名(85.1%;95%CI 81.39-88.5)患者被分类为 ILD-CTD(类风湿关节炎 31%,系统性硬化症 29%,皮肌炎 15%)。36 名患者被分类为 IPAF(9.5%;95%CI 6.9-12.8),13 名(3.5%;95%CI 2-5.75)为 ILD-ANCA。50%的患者(95%CI 45.12-55.43)在诊断时出现用力肺活量轻度下降。最常见的治疗策略是类固醇和环磷酰胺联合治疗(30.1%;95%CI 25.32-35.34),其次是硫唑嘌呤(20.3%;95%CI 16.32-25.14)。总之,据我们所知,这是第一项评估拉丁美洲自身免疫性间质性肺病患者特征和治疗策略的研究。未来的研究应评估当前治疗策略对自身免疫性间质性肺病患者的预后和影响。

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