Idiopathic pulmonary fibrosis with emphysema: evidence of synergy among emphysema and idiopathic pulmonary fibrosis in smokers

Emphysema and fibrosis, typically the idiopathic pulmonary fibrosis (IPF) form of usual interstitial pneumonia (UIP), can co-exist as combined pulmonary fibrosis emphysema (CPFE). It is unknown whether there is a pathobiologic basis for CPFE beyond the coexistence of fibrosis and emphysema. The aim...

Full description

Saved in:
Bibliographic Details
Published in:Respiratory care 2015-02, Vol.60 (2), p.259-268
Main Authors: Mitchell, Patrick D, Das, Jeeban P, Murphy, David J, Keane, Michael P, Donnelly, Seamas C, Dodd, Jonathan D, Butler, Marcus W
Format: Article
Language:English
Subjects:
Aged
Arthritis, Rheumatoid - complications
Asbestosis - complications
Development and progression
Emphysema, Pulmonary
Female
Health aspects
Humans
Idiopathic Pulmonary Fibrosis - complications
Idiopathic Pulmonary Fibrosis - diagnostic imaging
Idiopathic Pulmonary Fibrosis - etiology
Male
Pulmonary Emphysema - complications
Pulmonary Emphysema - diagnostic imaging
Pulmonary fibrosis
Retrospective Studies
Scleroderma, Systemic - complications
Severity of Illness Index
Single-Blind Method
Smokers
Smoking - adverse effects
Tomography, X-Ray Computed
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Emphysema and fibrosis, typically the idiopathic pulmonary fibrosis (IPF) form of usual interstitial pneumonia (UIP), can co-exist as combined pulmonary fibrosis emphysema (CPFE). It is unknown whether there is a pathobiologic basis for CPFE beyond the coexistence of fibrosis and emphysema. The aim of this study was to ascertain radiologic differences in severity of fibrosis and emphysema in smokers with IPF versus other forms of UIP. Computed tomography thorax images were prospectively rescored in retrospectively identified smokers (minimum 5-pack-year history) with radiologic UIP (any etiology). Radiologic severity (emphysema/fibrosis/reticulation) was scored in consensus by two radiologists, blinded to clinical details, across 5 lung regional levels, and then correlated with clinical data. For the whole cohort (IPF, n=102; non-IPF UIP [mainly rheumatoid arthritis/asbestosis/scleroderma], n=30), IPF and non-IPF UIP smokers were similar regarding pack-year, age, gender, and lung function (P>.1). IPF smokers had greater whole lung fibrosis and reticulation scores (P.1). There were significantly greater regional reticulation severity (P=.009), cumulative emphysema severity (P=.04), and cumulative reticulation severity (P
ISSN:0020-1324
1943-3654
DOI:10.4187/respcare.03389