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• W2891210738 abstract "INTRODUCTION :Diffuse parenchymal lung diseases (DPLD) are a diverse group of pulmonarydisorders that are classified together because of similar clinical, roentgenographic,physiologic, or pathologic manifestations1. They are also referred to as interstitial lungdiseases (ILD).DPLD alter mechanical and gas exchange properties of the lungs. Ingeneral, the hall marks of DPLD are restrictive changes in pulmonary physiology i.edecreased total lung capacity, reduced residual volume, diminished static compliance andreduced vital capacity often with an increased FEV1/FVC ratio and a reduced diffusingcapacity with carbon monoxide.Hence pulmonary function testing (PFT) aids in the evaluation and managementof patients with DPLD by provide an estimate of histologic severity, baseline estimationof prognosis and be used to monitor disease progression or response to therapy. Theforced vital capacity and diffusion capacity are the most valuable serial measurements fordiagnosing DPLD.The collagen vascular diseases are a heterogeneous group of immunologicallymediated inflammatory diseases. It is not surprising that, by virtue of their abundantconnective tissue and blood supply, the lungs are frequently involved in these disorders.Consequently, collagen vascular diseases affect all areas of the lung (i.e. airways,alveoli, vascular system, and pleura), and do so in various degrees and combinations2.Diffuse parenchymal lung diseases in CVD patients are characterised bydeteriorating parenchymal fibrosis and gas exchange. It remains innocuous in the earlystage, as most of the rheumatic patients have restricted mobility manifesting with subtleor nil pulmonary symptoms. Hence, the respiratory physician should be prudent indiagnosing the cases as early as possible. Because the pulmonary specialist ofteninvolved in care of these patients, a comprehensive understanding of collagen vasculardisease and usual course of Diffuse parenchymal lung diseases are important.AIM OF THE STUDY :To evaluate the Diffusing capacity for carbon monoxide among patients withDiffuse parenchymal lung disease in proven Rheumatologic illness showing variouspattern of abnormalities in the High Resolution Computerised Tomography and correlatethe same with spirometry.DESIGN OF THE STUDY : Prospective study. Approval from Medical Ethical Committee has been obtained.MATERIALS AND METHODSThis prospective study was organized in the Institute of Thoracic medicine anddepartment of Thoracic medicine, Government General Hospital in association withdepartment of Rheumatology, Government General Hospital. Subjects were recruitedfrom the Pulmonary and Rheumatology outpatient clinic of our hospital. This study wasapproved by the ethical committee of this institution.The design of the work is a prospective study. The study extended from the periodof January 2008 to November 2008 and it was performed at the Institute of Thoracicmedicine with the same population referred from the department of Rheumatology,Government General Hospital, Chennai.INCLUSION CRITERIA :1. Clinically and radiologically confirmed cases of DPLD.2. Age > 12 years.3. Sex- Both genders.4. Patients who are able to perform spirometry and diffusion capacity with abreath holding period of at least 10 seconds.5. Serologically positive collagen vascular disease patients.EXCLUSION CRITERIA :1. Patient associated with history suggestive of Infection, Allergy andimmunosuppression.2. Patient associated with any other respiratory disease, cardiovasculardisease, and malignancy.3 Smokers are virtually eliminated from the study as a confounding factor(For example respiratory bronchiolitis of smoking can be falsely attributedto collagen vascular disease).4. DPLD due to other causes or of unknown aetiology.5. Breath-holding time 11 seconds, or with an inspiratory capacityless than 85% of the largest previously measured vital capacity.RESULTS :In our study 55 patients were screened for Diffuse Parenchymal Lung Diseaseswith collagen vascular diseases. Out of which 36 patients were taken up for the studyafter satisfying eligible criteria. All were nonsmokers. Remaining patients were excludedfrom the study group based on exclusion criteria.CONCLUSION :Altered DLCO may be the first and only abnormality found in early stage ofDiffuse parenchymal lung diseases. The earlier discussed studies show the correlationbetween individual collagen vascular disease and pulmonary function testing. But thisstudy focuses on evaluation of Diffusing capacity for carbon monoxide among patientswith Diffuse parenchymal lung diseases in all classified Collagen vascular diseasesshowing various HRCT pattern abnormalities and correlate the same with spirometry.Among the various combinations of HRCT patterns in Collagen vascular diseasespresence of Honeycombing is associated with significant severe reduction in DLCO andDLCOHb with varying grades of severity in Forced vital capacity.When individualHRCT patterns analysed Honey combing and Traction bronchiectasis patterns havesignificant severe reduction in DLCO and DLCOHb with varying grades of spirometryseverity .When DLCO and DLCOHb are within normal limits the reduction in Forced vitalcapacity has to be correlated with age factor.In summary DLCO and DLCOHb are in significant association with spirometry.The percent predicted DLCO and DLCOHb best reflect the extent of Honeycombingwhich is considered as fibrotic index in Diffuse parenchymal lung diseases with Collagenvascular diseases, and therefore should be measured in routine evaluations.So we conclude DLCO and DLCOHb in collagen vascular disease will be of usein initial evaluation of severity of collagen vascular disease as well as to assess theresponse to treatment in these disorders." @default.
• W2891210738 created "2018-09-27" @default.
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• W2891210738 date "2009-03-01" @default.
• W2891210738 modified "2023-09-24" @default.
• W2891210738 title "Patterns of diffuse parenchymal lung disease manifestations in collagen vascular disease and in relation to DLCO" @default.
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