A hospital based cross sectional study of clinical picture and spirometry pattern on interstitial lung diseases at a tertiary care centre

Authors

  • Roshan Lal Department of Chest and TB, Government Medical College, Ambikapur, Chhattisgarh, India
  • Pratik Kumar Department of Chest and TB, Chhattisgarh Institute of Medical Sciences, Bilaspur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20193272

Keywords:

Clinical picture, Clubbing, Dyspnoea, Serum ACE level, Spirometry pattern

Abstract

Background: Many of the ILDs are difficult to differentiate on clinical examination and history as they have similar clinical features. Symptom complex is not beyond that of respiratory symptoms. The objective was to study the clinical picture and spirometry pattern of the patients having interstitial lung disease.

Methods: Hospital based cross sectional study was carried out among 73 cases of ILDs. Data related to history, clinical examination was recorded. Six minute walk test and spirometry was carried out. The data was analysed using proportions.

Results: Incidence of Idiopathic pulmonary fibrosis (IPF) increased with age. Exertional dyspnea (100%) and cough (95.9%) were the commonest presenting symptoms amongst ILD patients. End inspiratory fine crackles (95.1%) and clubbing (67.1%) are the predominant clinical signs. Mean BMI of various ILDs patients were 24.86±8.2 Kg/m² in NSIP followed by 22.9±4.6 in sarcoidosis 21.9±6.4 and 20.8±3.94 in IPF and in Cryptogenic Organizing Pneumonias 19.34±1.8 Kg/M². Serum ACE level was raised in 69.2% patients of sarcoidosis. 81 % of patients could successfully perform 6 Minute Walk Test. Among those who could perform, average desaturation was 8.11% in sarcoidosis, 7.52% in IPF, 6.0% In Hypersensitivity Pneumonitis, 5.75% in NSIP and 4.75% in CTD associated ILDs patients. Raised C Reactive Protein label was consistent (45.2%) in ILDs, maximum in HP (63%) and 2 out of 3 patients with COP and 3 out of 5 patients of CTD associated ILDs. 17.8% cases had positive serum ANA, maximum in IPF.

Conclusions: Idiopathic pulmonary fibrosis (IPF) was the commonest Interstitial Lung disease present in 39.7% of 73 cases followed by sarcoidosis in 17.9%, cases.

References

Coultas DB, Zumwalt RE, Black WC, Sobonya RE. The epidemiology of interstitial lung diseases. Am J Respir Crit Care Med. 1994;150(4):967-72.

Savarino E, Carbone R, Marabotto E, Furnari M, Sconfienza L, Ghio M, et al. Gastro-oesophageal reflux and gastric aspiration in idiopathic pulmonary fibrosis patients. Eur Resp J. 2013;42(5):1322-31.

Raghu G, Rochwerg B, Zhang Y, Garcia CA, Azuma A, Behr J, et al. An official ATS/ERS/JRS/ALAT clinical practice guideline: treatment of idiopathic pulmonary fibrosis. An update of the 2011 clinical practice guideline. Am J Respir Crit Care Med. 2015;192(2):e3-19.

Hamada K, Nagai S, Tanaka S, Handa T, Shigematsu M, Nagao T, et al. Significance of pulmonary arterial pressure and diffusion capacity of the lung as prognosticator in patients with idiopathic pulmonary fibrosis. Chest. 2007;131(3):650-6.

Gagiya AK, Suthar HN, Bhagat GR. Clinical Profile of Interstitial Lung Disease Cases. Natl J Med Res 2012;2:01-4.

Sen T, Udwadia ZF. Retrospective study of interstitial lung disease in a tertiary care centre in India. Ind J Chest Dis Allied Sci. 2010;52(4):207-11.

Verma SK, Prasad R, Anant SC, Shukla AD, Surya Kant GM. A study of diffuse parenchymal lung disease. Pulmon. 2008;10(3):94-7.

Shafeeq MK, Anithakumari K, Fathahudeen A, Jayaprakash B, Win R, Sreekala RS, et al. Aetiology and clinic-radiological profile of interstitial lung disease in a tertiary care centre. Cough. 2011;63:90-0.

Maheshwari U, Gupta D, Aggarwal AN, Jindal SK. Spectrum and diagnosis of idiopathic pulmonary fibrosis. Ind J Chest Dis Allied Sci. 2004;46(1):23-6.

Kumar R, Gupta N, Goel N. Spectrum of interstitial lung disease at a tertiary care centre in India. Adv Resp Med. 2014;82(3):218-26.

Abeles AM, Abeles M. The clinical utility of a positive antinuclear antibody test result. Am J Med. 2013;126(4):342-8.

Weinberg I, Vasiliev L, Gotsman I. Anti dsDNA antibodies in sarcoidosis. Semin Arthritis Rheum 2000;29(5):328-31.

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Published

2019-07-24

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Original Research Articles