Analysis of the clinical features of 57 patients with pathological proven connective tissue disease-related organizing pneumonia
10.3760/cma.j.issn.1007-7480.2015.06.004
- VernacularTitle:结缔组织病相关性机化性肺炎的临床特点
- Author:
Xin DONG
;
Yi ZHENG
;
Li WANG
;
Yungang ZHANG
- Publication Type:Journal Article
- Keywords:
Connective tissue diseases;
Lung diseases,interstitial;
Organizing pneumonia
- From:
Chinese Journal of Rheumatology
2015;(6):374-379
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of connective tissue diseases (CTD) related organizing pneumonia (OP). Methods The clinical and radiological features, therapy and outcome of 57 CTD-OP patients diagnosed by biopsy were retrospectively analyzed. T test, x2 test, Pearson/Spearmanˊs correla-tion analysis were used for statistical analysis with software version 15.0. Results CTD-OP accounted for 44% of all the OP. There were 36 cases (63%) with the initial clinical manifestation of OP in CTD-OP patients. The underling primary disease of CTDs included Sj?grenˊs syndrome (22, 38%), polymyositis/dermatomyositis (13, 23%), RA (13, 23%) and undifferentiated connective tissue diseases (9, 16%). At baseline, the clinical symptoms of cough and malaise [54% vs 83%, x2=7.749, P=0.005; 49% vs 71%, x2=4.007, P=0.045] were significantly lower in the CTD-OP patients than in the COP patients. The signs of moist rales and crackles (54% vs 32%, x2=4.160, P=0.041; 49% vs 27%, x2=4.529, P=0.033) were more common in the CTD-OP patients than in the COP patients. The TLC%, FVC% of the lung function reduced significantly in CTD-OP patients than in COP patients [(72 ±18)% vs (97 ±29)%, t=-2.475, P=0.027;(75 ±26)% vs (96 ±23)%, t=-2.174, P=0.039). The dosage of corticosteroids [(44 ±14) mg/d vs (37 ±10) mg/d, t=2.541, P=0.013] were significantly higher in the CTD-OP patients than in the COP patients. The complete recovery rate was slightly lower in CTD-OP than in COP (22% vs 29%, x2=0.384, P=0.483) with a tendency towards higher recurrence rate in CTD-OP (33% vs 14%, x2=4.007, P=3.958). Conclusion CTD-OP is probably the common cause of OP. OP can be the initial manifestation of CTD. The primary disease of the CTD-OP includes Sjogrenˊs syndrome, polymyositis/dermatomyositis, rheumatoid arthritis and undifferentiated connective tissue diseases. Compared with COP, CTD-OP patients may have milder clinical symptoms, but the more severe damage of the lung, the higher the recurrence rate, therefore, CTD-OP is worthy of more attention from rheumatologists.
