Higo Hisao, Ichikawa Hirohisa, Arakawa Yukako, Mori Yoshihiro, Tamura Tomoki, Kuyama Shoichi, Matsumoto Chiaki, Sugimoto Keisuke, Hamada Noboru, Suwaki Toshimitsu, Itano Junko, Tanimoto Yasushi, Senoo Satoru, Taniguchi Akihiko, Inukai Yumi, Arita Machiko, Makimoto Satoko, Kojima Katsuhide, Matsushita Takashi, Maeda Yoshinobu, Miyahara Nobuaki
Department of Allergy and Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Department of Respiratory Medicine, KKR Takamatsu Hospital, 4-18 Tenjinmae, Takamatsu 760-0018, Japan.
J Clin Med. 2024 Nov 15;13(22):6870. doi: 10.3390/jcm13226870.
There are cases of idiopathic interstitial pneumonias (IIPs) that do not meet the diagnostic criteria for connective tissue disease but have clinical features suggestive of autoimmune process. Interstitial pneumonia with autoimmune features (IPAF) was recently proposed as a research concept for these patients. Although several prospective studies on IPAF have been conducted, its clinical significance in cryptogenic organizing pneumonia (COP) remains unclear. : Patients aged ≥20 years with suspected COP were prospectively enrolled between June 2018 and December 2022. Among the enrolled patients, those diagnosed with COP based on computed tomography (CT) and bronchoalveolar lavage (BAL) findings were compared between the IPAF and non-IPAF groups. : A total of 56 patients were enrolled in this study. Of these, 30 were diagnosed with COP and included in the analysis. Clinical and serological features were positive in two and six patients, respectively. Each feature was exclusive, and eight patients (26.7%) were diagnosed with IPAF. There were no differences between the IPAF and non-IPAF groups in terms of clinical features, including BAL findings, laboratory data, CT findings, and clinical course. During the one-year follow-up period, the frequency of COP exacerbation did not differ between the IPAF and non-IPAF groups, and no cases of systemic autoimmune disease or death occurred in either group. : The COP characteristics of the IPAF and non-IPAF groups are similar in all aspects, and distinguishing between the two groups may be of little significance.
有一些特发性间质性肺炎（IIP）病例不符合结缔组织病的诊断标准，但具有提示自身免疫过程的临床特征。具有自身免疫特征的间质性肺炎（IPAF）最近被提出作为这些患者的一个研究概念。尽管已经对IPAF进行了几项前瞻性研究，但其在隐源性机化性肺炎（COP）中的临床意义仍不清楚。：2018年6月至2022年12月期间前瞻性纳入了年龄≥20岁的疑似COP患者。在纳入的患者中，根据计算机断层扫描（CT）和支气管肺泡灌洗（BAL）结果诊断为COP的患者在IPAF组和非IPAF组之间进行了比较。：本研究共纳入56例患者。其中，30例被诊断为COP并纳入分析。临床和血清学特征分别在2例和6例患者中呈阳性。每个特征都是排他性的，8例患者（26.7%）被诊断为IPAF。IPAF组和非IPAF组在临床特征方面没有差异，包括BAL结果、实验室数据、CT结果和临床病程。在一年的随访期内，IPAF组和非IPAF组之间COP加重的频率没有差异，两组均未发生系统性自身免疫疾病或死亡病例。：IPAF组和非IPAF组的COP特征在各方面都相似，区分这两组可能意义不大。
