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Research Paper | Medical Science | Brazil | Volume 12 Issue 12, December 2023
Fibrosing Interstitial Lung Diseases: Characteristics of Patients Attended at a Brazilian Public University Hospital
Jessica Carniel Beltrami | Anye Caroline Mattiello | Marilia Martins Melgaco
Abstract: Background and objectives: Define the epidemiological profile, radiological and or histological characteristics of patients with fibrosinginterstitial lung diseases (FILDs), in addition to determining diagnostic methods, lung functional capacity and treatments performed for these patients. Materials and methods: Retrospective cross-sectional observational study carried out with patients with FILDs in the pulmonology outpatient clinic of the Hospital Universit?rioCajuru (HUC) at the Pontif?cia Universidade Cat?lica do Paran? (PUC-PR) in Brazil, between January 2017 and December 2017. Data from medical records of 53 patients with interstitial lung diseases (ILDs) including physical examination findings, tomographic patterns; presence or absence of transbronchial biopsy and cellularity of bronchoalveolar lavage if performed. All information wasreviewed and inserted into an Excel spreadsheet. Data analysis was carried out using the SPSS v.22.0 computer program. The results were expressed as means, medians, minimum values and standard deviations or as frequencies and percentages. Inferential analysis was carried out using statistical tests relevant to the study, such as Chi Square, Fischer?s exact Test and Student?s T Test. The comparative analysis between radiologists in terms of tomographic criteria was performed using the Kappa coefficient of agreement. Results: Of the 53 patients initially selected, 43 met all inclusion criteria. Of these patients, there was a slight predominance of female patients (53%) and a mean age of 62.2 years. Of the clinical characteristics evaluated, 49% had exposure (mold or birds). Most patients did not undergo surgical lung biopsy (82%) and only 32% underwent transbronchial biopsy (TBB). Bronchoalveolar lavage (BAL) was performed in 60% of cases. Of the patients who underwent BAL (25 of 43), 20 of them had a predominance of lymphocytes in the cell differential. Regarding the treatment of these patients, 17 (40%) received treatment with corticosteroids, 9 (21%) with immunosuppressants. Of the 43 patients evaluated, 23 (53%) did not have a definitive diagnosis or were still under etiological investigation and, therefore, did not receive any treatment. Regarding the degree of agreement between radiologists, it was observed that there was very good agreement in the presence of the ground glass finding (71% of cases) k=0.83 (95% CI 0.61-1.0) and the presence of Velcrocrackles was significantly correlated with the drop in FVC, with FVC of 50% (average) in relation to predicted. Conclusions: The FILDs affects elderly patients more, with a slightly higher prevalence among women. A relevant number of patients (49%) were exposed to mold and bird feathers, which suggests a greater number of possible diagnoses of hypersensitivity pneumonitis (HP).Although much has been learned about FILDs in recent decades, more research in this area is needed. It is clear that MDD (multidisciplinary discussion) improves the possibilities of diagnostic accuracy, and that functional tests more accurately predict the severity and speed of progression of ILDs.
Keywords: interstitial, radiologic, histologic, fibrosis, pneumonitis
Edition: Volume 12 Issue 12, December 2023,
Pages: 1910 - 1916