ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Radiographic Patterns of Lung Disease in Patients with Connective Tissue Disease Associated Interstitial Lung Disease (CTD-ILD)
Session Title
TP126 - TP126 STRUCTURE AND FUNCTION IN PARENCHYMAL LUNG DISEASES
Abstract
A4652 - Radiographic Patterns of Lung Disease in Patients with Connective Tissue Disease Associated Interstitial Lung Disease (CTD-ILD)
Author Block: E. S. Randhawa1, D. Jain2, H. Zhao1, G. J. Criner3, E. Narewski4; 1Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, United States, 2Internal Medicine, Temple University, Philadelphia, PA, United States, 3Pulm & Crit Care Med, Temple Univ Hosp, Philadelphia, PA, United States, 4Department of Thoracic Medicine and Surgery, Temple Hospital, Philadelphia, PA, United States.
Introduction: Interstitial lung disease (ILD) is a leading cause of mortality1 in patients with Connective Tissue Disease (CTD). Although prevalence varies, all patients with CTD are at risk for developing diverse patterns of ILD as determined by high resolution computed tomography (HRCT).2, 3 The two most common patterns include the usual interstitial pneumonia pattern (UIP) and the non-specific interstitial pneumonia pattern (NSIP). In addition, the exuberant honeycombing sign, anterior upper lobe sign, and the straight-edge sign are additional HRCT signs associated with CTD-ILD but previously demonstrated only in patients with UIP.4 We hypothesized that these additional signs would be present in patients with both NSIP and UIP ILD patterns. Methods: We performed a retrospective chart review of 100 patients with a diagnosis of CTD by American College of Rheumatology criteria who received care at the Temple Lung Center in Philadelphia, PA for CTD-ILD between 2013 and 2020. All patients received a HRCT at time of ILD diagnosis, which was categorized as NSIP or UIP, and which was analyzed for the presence of additional signs. 32 patients were excluded. Exclusion criteria included a comorbid diagnosis of cancer, end stage renal disease, end stage liver disease, or inadequate data for analysis. Patients were separated into two groups by ILD pattern. Results: Of the 68 patients analyzed, 44 (65%) had an NSIP pattern and 24 (35%) had a UIP pattern. No differences were identified between the CTD-ILD patients with NSIP when compared to the CTD-ILD patients with UIP in age, gender, smoking status or history, diagnosis of CTD by American College of Rheumatology (ACR) criteria, or pulmonary function test results. The exuberant honeycombing sign and the anterior upper lobe sign were both more prevalent in patients with UIP, but were found in both groups. The anterior upper lobe sign was present in NSIP patients 52% of the time. The shelf/straight edge sign was not identified in any patients. Conclusions: In this small cohort of patients with CTD-ILD, the anterior upper lobe sign was noted in both patients with UIP and patients with NSIP, in whom was present in 52% of cases analyzed.
Author Block: E. S. Randhawa1, D. Jain2, H. Zhao1, G. J. Criner3, E. Narewski4; 1Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, United States, 2Internal Medicine, Temple University, Philadelphia, PA, United States, 3Pulm & Crit Care Med, Temple Univ Hosp, Philadelphia, PA, United States, 4Department of Thoracic Medicine and Surgery, Temple Hospital, Philadelphia, PA, United States.
Introduction: Interstitial lung disease (ILD) is a leading cause of mortality1 in patients with Connective Tissue Disease (CTD). Although prevalence varies, all patients with CTD are at risk for developing diverse patterns of ILD as determined by high resolution computed tomography (HRCT).2, 3 The two most common patterns include the usual interstitial pneumonia pattern (UIP) and the non-specific interstitial pneumonia pattern (NSIP). In addition, the exuberant honeycombing sign, anterior upper lobe sign, and the straight-edge sign are additional HRCT signs associated with CTD-ILD but previously demonstrated only in patients with UIP.4 We hypothesized that these additional signs would be present in patients with both NSIP and UIP ILD patterns. Methods: We performed a retrospective chart review of 100 patients with a diagnosis of CTD by American College of Rheumatology criteria who received care at the Temple Lung Center in Philadelphia, PA for CTD-ILD between 2013 and 2020. All patients received a HRCT at time of ILD diagnosis, which was categorized as NSIP or UIP, and which was analyzed for the presence of additional signs. 32 patients were excluded. Exclusion criteria included a comorbid diagnosis of cancer, end stage renal disease, end stage liver disease, or inadequate data for analysis. Patients were separated into two groups by ILD pattern. Results: Of the 68 patients analyzed, 44 (65%) had an NSIP pattern and 24 (35%) had a UIP pattern. No differences were identified between the CTD-ILD patients with NSIP when compared to the CTD-ILD patients with UIP in age, gender, smoking status or history, diagnosis of CTD by American College of Rheumatology (ACR) criteria, or pulmonary function test results. The exuberant honeycombing sign and the anterior upper lobe sign were both more prevalent in patients with UIP, but were found in both groups. The anterior upper lobe sign was present in NSIP patients 52% of the time. The shelf/straight edge sign was not identified in any patients. Conclusions: In this small cohort of patients with CTD-ILD, the anterior upper lobe sign was noted in both patients with UIP and patients with NSIP, in whom was present in 52% of cases analyzed.
