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interstitial lung disease guidelines

Fernando J Martinez, Alison Chisholm, Harold R Collard, Kevin R Flaherty, Jeffrey Myers, Ganesh Raghu, Simon L F Walsh, Eric S White, Luca Richeldi
With the recent development of two effective treatments for patients with idiopathic pulmonary fibrosis, an accurate diagnosis is crucial. The traditional approach to diagnosis emphasises the importance of thorough clinical and laboratory evaluations to exclude secondary causes of disease. High-resolution CT is a critical initial diagnostic test and acts as a tool to identify patients who should undergo surgical lung biopsy to secure a definitive histological diagnosis of usual interstitial pneumonia pattern...
January 2017: Lancet Respiratory Medicine
Marcos García-Nava, Heidegger Mateos-Toledo, Ana Patricia Georgina Guevara-Canseco, Cesar Eduardo Infante-González, Diego Alberto Reyes-Nava, Emilio Estrada-Castro
Microscopic polyangiitis (MPA) is a systemic disease included in the Chapel Hill 2012 Classification as necrotizing vasculitis affecting capillaries, venules and arterioles. It usually expresses antineutrophil cytoplasmic antibodies (ANCA) and has a perinuclear immunofluorescence pattern and correlation with anti-myeloperoxidase (MPO) antibodies. Capillaritis with alveolar hemorrhage is the most common manifestation of lung disease. Interstitial lung disease (ILD) is uncommon, with usual interstitial pneumonia being the predominant pattern...
December 2, 2016: Reumatología Clinica
Jamie S Sheth, John A Belperio, Michael C Fishbein, Ella A Kazerooni, Amir Lagstein, Susan Murray, Jeff L Myers, Richard H Simon, Thomas H Sisson, Baskaran Sundaram, Eric S White, Meng Xia, David Zisman, Kevin R Flaherty
BACKGROUND: Surgical lung biopsy (SLB) is invasive and not possible in all patients with undiagnosed interstitial lung diseases (ILD). We hypothesized that transbronchial biopsy (TBB) findings combined with clinical and high resolution computed tomography (HRCT) data leads to a confident diagnosis congruent to SLB, and therefore avoids the need for SLB in some patients. METHODS: We evaluated 33 patients being evaluated for suspected ILD who underwent HRCT, TBB and SLB...
October 8, 2016: Chest
Manuela Funke, Thomas Geiser, Otto D Schoch
In 2015, the international guidelines for diagnosis and treatment of pulmonary hypertension (PH) were updated. Group 3 of the current classification includes PH associated with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), other pulmonary diseases with restrictive and obstructive pattern, sleep-disordered breathing, alveolar hypoventilation disorders, chronic exposure to high altitude, and developmental lung diseases [1]. PH associated with COPD and ILD is common but difficult to manage, as no long-term randomised controlled trial (RCT) has been conducted with specific pulmonary arterial hypertension (PAH) drugs in PH associated with COPD, and the one recent RCT in PH associated with ILD had to be stopped early due to a possible increased risk of death and side effects in the treatment group...
2016: Swiss Medical Weekly
John P Hutchinson, Tricia M McKeever, Andrew W Fogarty, Vidya Navaratnam, Richard B Hubbard
International guidelines and new targeted therapies for idiopathic pulmonary fibrosis have increased the need for accurate diagnosis of interstitial lung disease (ILD), which may lead to more surgical lung biopsies. This study aimed to assess the risk of this procedure in patients from the UK.We used Hospital Episodes Statistics data from 1997 to 2008 to assess the frequency of surgical lung biopsy for ILD in England, UK. We identified cardiothoracic surgical patients using International Classification of Diseases revision 10 codes for ILD and Office of Population Censuses and Surveys Classification of Interventions and Procedures version 4 codes for surgical lung biopsy...
November 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Mosavir Ansarie
No abstract text is available yet for this article.
September 2016: JPMA. the Journal of the Pakistan Medical Association
Heleen A Crommelin, Leone M van der Burg, Adriane D M Vorselaars, Marjolein Drent, Coline H M van Moorsel, Ger T Rijkers, Vera H M Deneer, Jan C Grutters
BACKGROUND: Tumor necrosis factor-alpha (TNF-α) inhibitors are regarded as the third-line therapy in sarcoidosis, the first choice generally being infliximab. To date, data regarding response to adalimumab in sarcoidosis patients intolerant to infliximab are lacking. The objective of this retrospective observational study was to establish if adalimumab could achieve stabilization or improvement of the disease in refractory sarcoidosis patients who developed intolerance to infliximab...
June 2016: Respiratory Medicine
Ammaiyappan Chockalingam, Ranganathan Duraiswamy, Madhavan Jagadeesan
BACKGROUND: Bronchoalveolar lavage (BAL) has gained acceptance for diagnosis of Interstitial lung disease (ILD). The advent of high-resolution computed tomography (HRCT) has reduced the clinical utility of BAL. This work has utilized the recommendations of the American Thoracic Society (ATS) to optimize BAL and the findings have been associated with clinical examination and HRCT to precisely narrow down the cause of ILD. MATERIALS AND METHODS: BAL was performed on ILD suspects at the target site chosen based on HRCT...
May 2016: Lung India: Official Organ of Indian Chest Society
Simon L F Walsh, Athol U Wells, Sujal R Desai, Venerino Poletti, Sara Piciucchi, Alessandra Dubini, Hilario Nunes, Dominique Valeyre, Pierre Y Brillet, Marianne Kambouchner, António Morais, José M Pereira, Conceição Souto Moura, Jan C Grutters, Daniel A van den Heuvel, Hendrik W van Es, Matthijs F van Oosterhout, Cornelis A Seldenrijk, Elisabeth Bendstrup, Finn Rasmussen, Line B Madsen, Bibek Gooptu, Sabine Pomplun, Hiroyuki Taniguchi, Junya Fukuoka, Takeshi Johkoh, Andrew G Nicholson, Charlie Sayer, Lilian Edmunds, Joseph Jacob, Maria A Kokosi, Jeffrey L Myers, Kevin R Flaherty, David M Hansell
BACKGROUND: Diffuse parenchymal lung disease represents a diverse and challenging group of pulmonary disorders. A consistent diagnostic approach to diffuse parenchymal lung disease is crucial if clinical trial data are to be applied to individual patients. We aimed to evaluate inter-multidisciplinary team agreement for the diagnosis of diffuse parenchymal lung disease. METHODS: We did a multicentre evaluation of clinical data of patients who presented to the interstitial lung disease unit of the Royal Brompton and Harefield NHS Foundation Trust (London, UK; host institution) and required multidisciplinary team meeting (MDTM) characterisation between March 1, 2010, and Aug 31, 2010...
July 2016: Lancet Respiratory Medicine
Julie Morisset, Cheilonda Johnson, Eric Rich, Harold R Collard, Joyce S Lee
Interstitial lung disease (ILD) is a frequent pulmonary manifestation and an important cause of morbidity and mortality in patients with idiopathic inflammatory myopathy. Myositis-related ILD presents a therapeutic challenge for clinicians, as there are no available guidelines to help with management decisions. This review covers the existing evidence on the pharmacologic and nonpharmacologic management of myositis-related ILD, highlighting the lack of randomized controlled data to guide treatment. Given the absence of existing guidelines to inform treatment decisions, we provide a comprehensive summary, including dosing, side effects, and suggested monitoring of the commonly used immunosuppressive agents and a proposed treatment algorithm based on the existing literature...
November 2016: Chest
Hanbo Chen, Alexander V Louie
Lobectomy is currently the guideline-recognized gold standard for the treatment of early-stage non-small cell lung cancer (ES-NSCLC) in patients who are surgical candidates. In patients who are not medically fit for surgery, stereotactic ablative radiotherapy (SABR) is the treatment of choice with good reported rates of local control and overall survival. For patients at high risk for lobectomy, sublobar resection (SLR) may achieve similar outcomes as lobectomy, especially for peripheral tumors ≤2 cm. While there are merits to both SLR and SABR for these high-risk patients, evidence is conflicting on which may be preferred in the context of clinical and cost-effectiveness outcomes...
June 2016: Current Treatment Options in Oncology
L V Artemoval, N V Baskova, T B Burmistrova, E A Buryakinal, I V Buhtiyarov, A Yu Bushmanov, O S Vasilyeva, V G Vlasov, Y Y Gorblyansky, S A Zhabina, O N Zaharinskaya, N F Ismerov, E V Kovalevsky, G V Kuznetsova, L P Kuzmina, T A Kunyaeva, I I Logvinenko, L A Lutsenko, N N Mazitova, T Yu Obukhova, O V Odintseva, G P Orlova, L A Panacheva, I N Piktushanskaya, A E Plyukhin, E L Poteryaeva, S M Pravilo, V V Razumov, N A Roslaya, O F Roslyi, O P Rushkevich, V A Semenihin, P V Serebryakov, E L Smirnova, N S Sorkina, E S Tsidil'kovskaya, E V Chasovskikh, L A Shpagina
The purpose of development of this clinical practice guidelines was to provide evidence-based protocols that help the practitioner and the patient make the right decision for the health assessment, treatment and prevention of pneumoconiosis. Pneumoconiosis is the interstitial lung disease of occupational origin caused by prolonged inhalation of inorganic dust, characterized by chronic diffuse aseptic inflammation in lung tissue with the development of pulmonary fibrosis. Currently, thereare no treatment that provide a cure pulmonary fibrosis and changes in the dynamics of decline in lung function...
2016: Meditsina Truda i Promyshlennaia Ekologiia
Beth Wallace, Dharshan Vummidi, Dinesh Khanna
PURPOSE OF REVIEW: Interstitial lung disease (ILD), though a common and often a severe manifestation of many connective tissue diseases (CTD), is challenging to manage because of its variable presentation and the relative lack of guidelines to assist the clinician. In this review, we discuss the approach to diagnosis, treatment, and monitoring patients with CTD-associated ILD, with a focus on systemic sclerosis (SSc), rheumatoid arthritis (RA), and idiopathic inflammatory myopathy (IIM)...
May 2016: Current Opinion in Rheumatology
Yanni F Yu, Ning Wu, Chien-Chia Chuang, Rosa Wang, Xiaoyun Pan, Nicole N Benjamin, Giovanna Devercelli, David B Coultas
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a rare and fatal restrictive respiratory disease under the idiopathic lung disease (ILD) class. IPF is a form of chronic, progressive fibrosing interstitial pneumonia and has more scarring, less inflammation, and poorer prognosis than most other ILD forms. Exacerbation of IPF is rapid, with unpredictable deterioration of lung function, and is associated with short-term mortality. The American Thoracic Society (ATS) evidence-based guidelines for diagnosis and management of IPF reports that the incidence of acute exacerbations is between 5%-10%...
April 2016: Journal of Managed Care & Specialty Pharmacy
Sang Hoon Lee, Song Yee Kim, Dong Soon Kim, Young Whan Kim, Man Pyo Chung, Soo Taek Uh, Choon Sik Park, Sung Hwan Jeong, Yong Bum Park, Hong Lyeol Lee, Jong Wook Shin, Eun Joo Lee, Jin Hwa Lee, Yangin Jegal, Hyun Kyung Lee, Yong Hyun Kim, Jin Woo Song, Moo Suk Park
Although a multidisciplinary approach has become an important criterion for an idiopathic pulmonary fibrosis (IPF) diagnosis, lung biopsies remain crucial. However, the prognosis of patients with surgically diagnosed IPF (sIPF) is uncertain. We aimed to investigate the prognosis of patients with clinically diagnosed IPF (cIPF) and sIPF. In this retrospective observational study, the Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of patients with IPF from January 1, 2003 to December 31, 2007...
March 2016: Medicine (Baltimore)
Cord Sunderkötter, Alexander Nast, Margitta Worm, Reinhard Dengler, Thomas Dörner, Horst Ganter, Reinhard Hohlfeld, Arthur Melms, Nico Melzer, Kai Rösler, Jens Schmidt, Michael Sinnreich, Maggi C Walter, Julia Wanschitz, Heinz Wiendl
The present guidelines on dermatomyositis (DM) represent an excerpt from the interdisciplinary S2k guidelines on myositis syndromes of the German Society of Neurology (available at The cardinal symptom of myositis in DM is symmetrical proximal muscle weakness. Elevated creatine kinase, CRP or ESR as well as electromyography and muscle biopsy also provide important diagnostic clues. Pharyngeal, respiratory, cardiac, and neck muscles may also be affected. Given that approximately 30% of patients also develop interstitial lung disease, pulmonary function tests should be part of the diagnostic workup...
March 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Paolo Spagnolo, Jean-François Cordier, Vincent Cottin
Connective tissue diseases encompass a wide range of heterogeneous disorders characterised by immune-mediated chronic inflammation often leading to tissue damage, collagen deposition and possible loss of function of the target organ. Lung involvement is a common complication of connective tissue diseases. Depending on the underlying disease, various thoracic compartments can be involved but interstitial lung disease is a major contributor to morbidity and mortality. Interstitial lung disease, pulmonary hypertension or both are found most commonly in systemic sclerosis...
May 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
C Robalo Cordeiro, P Campos, L Carvalho, S Campainha, S Clemente, L Figueiredo, J M Jesus, A Marques, C Souto-Moura, R Pinto Basto, A Ribeiro, M Serrado, A Morais
Idiopathic pulmonary fibrosis is a rare interstitial lung disease included in the Idiopathic Interstitial Pneumonias group. Although several potential risk factors have been described, it is a progressive fibrosing disease of unknown cause affecting mainly adults over 50 years and associated with a poor prognosis, reflected in a median survival of 2-3 years after diagnosis. The concept of a multidisciplinary working group for the diagnosis of idiopathic pulmonary fibrosis is based on the need to have experienced pulmonologists, radiologists and pathologists in the evaluation and correct treatment of the disease, and requires the use of all available data about individual patients, standardized (largely through High Resolution Computed Tomography and pathology when needed) as well as non-standardized data (laboratory, serology and biomarkers)...
March 2016: Revista Portuguesa de Pneumologia
Shouchun Peng, Yaxuan Liu, Xueren Li, Luqing Wei
OBJECTIVE: To compare the strengths and limitations of the old and revised guidelines for the diagnosis in patients with idiopathic pulmonary fibrosis(IPF). METHODS: Patients who were admitted and diagnosed as interstitial lung diseases (ILDs) in our hospital from 2009 to 2014 were enrolled in our study.Eachpatient was reevaluated respectively according to the old and revised guidelines of IPF. RESULTS: A total of 553 cases were initially reviewed, among whom 355 cases were excluded for pulmonary fibrosis secondary to definite underlying diseases, 28 excluded due to high resolution computed tomography(HRCT) not done, 26 excluded because serum immunology examination was not available...
February 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Jiri Vymetal, Martina Skacelova, Andrea Smrzova, Anna Klicova, Marketa Schubertova, Pavel Horak, Josef Zadrazil
BACKGROUND AND AIM: Rheumatic diseases are commonly considered chronic conditions. However, acute manifestations can be very severe and represent a diagnostic problem. Examples are systemic lupus erythematosus with acute flare, glomerulonephritis, CNS disorders and catastrophic antiphospholipid syndrome, scleroderma with interstitial lung disease, pulmonary hypertension and renal crisis and polyangiitis with alveolar haemorhage and acute respiratory failure. This aim of this paper is to overview emergency situations which can be encountered in the care of patients with autoimmune systemic diseases and vasculitides...
March 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
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