Chronic hypersensitivity pneumonitis is associated with an increased risk of venous thromboembolism: a retrospective cohort study

• Published in: BMC pulmonary medicine 2021-12, Vol.21 (1), p.416-416, Article 416
• Main Authors: Sobiecka, Małgorzata, Szturmowicz, Monika, Lewandowska, Katarzyna, Kowalik, Agata, Łyżwa, Ewa, Zimna, Katarzyna, Barańska, Inga, Jakubowska, Lilia, Kuś, Jan, Langfort, Renata, Tomkowski, Witold
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Alveolitis; Alveolitis, Extrinsic Allergic - complications; Alveolitis, Extrinsic Allergic - epidemiology; Anticoagulants; Antigens; Chronic Disease; Chronic hypersensitivity pneumonitis; Cohort analysis; Cohort Studies; Complications and side effects; Confidence intervals; Deep vein thrombosis; Disease; Female; Fibrosis; Humans; Hypersensitivity; Hypersensitivity pneumonitis; Hypertension; Idiopathic pulmonary fibrosis; Idiopathic Pulmonary Fibrosis - complications; Idiopathic Pulmonary Fibrosis - epidemiology; Lung diseases; Male; Medical prognosis; Middle Aged; Mortality; Patients; Pneumonitis; Poland - epidemiology; Prevention; Pulmonary embolism; Pulmonary embolisms; Pulmonary fibrosis; Pulmonology; Retrospective Studies; Risk Factors; Steroid hormones; Survival; Survival analysis; Thromboembolism; Thrombosis; Venous thromboembolism; Venous Thromboembolism - complications; Venous Thromboembolism - epidemiology; Venous thrombosis
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-021-01794-y

Idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis share commonalities in pathogenesis shifting haemostasis balance towards the procoagulant and antifibrinolytic activity. Several studies have suggested an increased risk of venous thromboembolism in IPF. The association between venous thromboembolism and chronic hypersensitivity pneumonitis has not been studied yet. A retrospective cohort study of IPF and chronic hypersensitivity pneumonitis patients diagnosed in single tertiary referral center between 2005 and 2018 was conducted. The incidence of symptomatic venous thromboembolism was evaluated. Risk factors for venous thromboembolism and survival among those with and without venous thromboembolism were assessed. A total of 411 (259 IPF and 152 chronic hypersensitivity) patients were included (mean age 66.7 ± 8.4 vs 51.0 ± 13.3 years, respectively). There were 12 (4.6%) incident cases of venous thromboembolism in IPF and 5 (3.3%) in chronic hypersensitivity pneumonitis cohort. The relative risk (RR) of venous thromboembolism in chronic hypersensitivity pneumonitis was not significantly different to that found in patients with IPF (7.1 vs 11.8/1000 person-years, RR 1.661 95% CI 0.545-6.019, respectively). The treatment with systemic steroids (OR 5.38; 95% CI 1.65-18.8, p = 0.006) and GAP stage 3 (OR 7.85; 95% CI 1.49-34.9; p = 0.037) were significant risk factors for venous thromboembolism in IPF. Arterial hypertension and pulmonary hypertension significantly increased risk of venous thromboembolism in chronic hypersensitivity pneumonitis. There were no significant differences in survival between patients with and without venous thromboembolism. The patients with chronic hypersensitivity pneumonitis have a marked increase in the risk of venous thromboembolism, similar to the patients with IPF. Venous thromboembolism does not affect the survival of patients with IPF and chronic hypersensitivity pneumonitis.