Interstitial Lung Disease and Anti-Myeloperoxidase Antibodies: Not a Simple Association
Por:
Sebastiani, M, Luppi, F, Sambataro, G, Villegas, DC, Cerri, S, Tomietto, P, Cassone, G, Bocchino, M, Atienza-Mateo, B, Cameli, P, Alvarado, PM, Faverio, P, Bargagli, E, Vancheri, C, Gonzalez-Gay, MA, Clini, E, Salvarani, C, Manfredi, A
Publicada:
1 jun 2021
Resumen:
Anti-neutrophil cytoplasmic antibodies (ANCA), mainly anti-myeloperoxidase (MPO) antibodies, have been frequently identified in patients with idiopathic pulmonary fibrosis (IPF). However, their role remains unclear, and only 7-23% of these patients develops clinically overt vasculitis. We aimed to investigate the clinical, serological, and radiological features and prognosis of anti-MPO-positive interstitial lung disease (ILD) patients. Fifty-eight consecutive patients firstly referred for idiopathic interstitial pneumonia and showing serological positivity of anti-MPO antibodies were retrospectively enrolled. For each patient, clinical data, lung function testing, chest high-resolution computed tomography (HRCT) pattern, and survival were recorded. Thirteen patients developed a rheumatic disease during a median follow-up of 39 months. Usual interstitial pneumonia (UIP) was the most frequent ILD pattern, significantly influencing the patients' survival. In fact, while the 52-week survival of the overall population was 71.4 +/- 7.5%, significantly higher than IPF, survivals of anti-MPO patients with UIP pattern and IPF were similar. Forced vital capacity and diffusion lung capacity for CO significantly declined in 37.7 and 41.5% of cases, respectively, while disease progression at chest HRCT was observed in 45.2%. A careful clinical history and evaluation should always be performed in ILD patients with anti-MPO antibodies to quickly identify patients who are developing a systemic rheumatic disease.
Filiaciones:
Sebastiani, M:
Univ Modena & Reggio Emilia, Azienda Osped Policlin Modena, Rheumatol Unit, I-41121 Modena, Italy
Luppi, F:
Univ Milano Bicocca, San Gerardo Hosp, Resp Unit, Dept Med & Surg,ASST Monza, I-20900 Monza, Italy
Sambataro, G:
Univ Catania, AOU Policlin Vittorio Emanuele, Reg Referral Ctr Rare Lung Dis, Dept Clin & Expt Med, I-95123 Catania, Italy
Villegas, DC:
Hosp Santa Creu & Sant Pau, Resp Dept, Barcelona 08041, Spain
Cerri, S:
Univ Modena & Reggio Emilia, Resp Unit, I-41121 Modena, Italy
Tomietto, P:
Univ Trieste, Rheumatol Unit, I-34127 Trieste, Italy
Cassone, G:
Univ Modena & Reggio Emilia, Azienda Osped Policlin Modena, Rheumatol Unit, I-41121 Modena, Italy
Univ Modena & Reggio Emilia, PhD Program Clin & Expt Med, I-41121 Modena, Italy
Bocchino, M:
Federico II Univ Hosp, Dept Clin Med & Surg, I-80131 Naples, Italy
Atienza-Mateo, B:
Hosp Univ Marques Valdecilla, IDIVAL, Dept Rheumatol, Santander 39011, Spain
Cameli, P:
Univ Siena, Dept Med Sci Surg & Neurosci, Resp Dis Unit, I-53100 Siena, Italy
Alvarado, PM:
Hosp Santa Creu & Sant Pau, Resp Dept, Barcelona 08041, Spain
Bargagli, E:
Univ Siena, Dept Med Sci Surg & Neurosci, Resp Dis Unit, I-53100 Siena, Italy
Vancheri, C:
Univ Catania, AOU Policlin Vittorio Emanuele, Reg Referral Ctr Rare Lung Dis, Dept Clin & Expt Med, I-95123 Catania, Italy
Gonzalez-Gay, MA:
Hosp Univ Marques Valdecilla, IDIVAL, Dept Rheumatol, Santander 39011, Spain
Univ Witwatersrand, Sch Physiol, Fac Hlth Sci, Cardiovasc Pathophysiol & Genom Res Unit, Johannesburg, South Africa
Clini, E:
Univ Modena & Reggio Emilia, Resp Unit, I-41121 Modena, Italy
Salvarani, C:
Univ Modena & Reggio Emilia, Azienda Osped Policlin Modena, Rheumatol Unit, I-41121 Modena, Italy
Irccs Arcispedale Santa Maria Nuova, Azienda Unita Sanitaria Locale IRCCS Reggio Emili, Rheumatol Unit, I-42124 Reggio Emilia, Italy
Manfredi, A:
Univ Modena & Reggio Emilia, Azienda Osped Policlin Modena, Rheumatol Unit, I-41121 Modena, Italy
gold, Green Published
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