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Prevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients

To determine the prevalence of lung abnormalities on chest computed tomography (CT) in patients with microscopic polyangiitis (MPA), to assess the responsiveness of such abnormalities to initial treatment, and to assess associations between these abnormalities and patient and disease characteristics... Full description

Journal Title: Arthritis & Rheumatology March 2016, Vol.68(3), pp.713-723
Main Author: Yamagata, Mieko
Other Authors: Ikeda, Kei , Tsushima, Kenji , Iesato, Ken , Abe, Mitsuhiro , Ito, Takashi , Kashiwakuma, Daisuke , Kagami, Shin‐Ichiro , Iwamoto, Itsuo , Nakagomi, Daiki , Sugiyama, Takao , Maruyama, Yuichiro , Furuta, Shunsuke , Jayne, David , Uno, Takashi , Tatsumi, Koichiro , Nakajima, Hiroshi
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ID: ISSN: 2326-5191 ; E-ISSN: 2326-5205 ; DOI: 10.1002/art.39475
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recordid: wj10.1002/art.39475
title: Prevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients
format: Article
creator:
  • Yamagata, Mieko
  • Ikeda, Kei
  • Tsushima, Kenji
  • Iesato, Ken
  • Abe, Mitsuhiro
  • Ito, Takashi
  • Kashiwakuma, Daisuke
  • Kagami, Shin‐Ichiro
  • Iwamoto, Itsuo
  • Nakagomi, Daiki
  • Sugiyama, Takao
  • Maruyama, Yuichiro
  • Furuta, Shunsuke
  • Jayne, David
  • Uno, Takashi
  • Tatsumi, Koichiro
  • Nakajima, Hiroshi
subjects:
  • Radiography, Thoracic
  • Tomography, X-Ray Computed
  • Lung Diseases -- Diagnostic Imaging
  • Microscopic Polyangiitis -- Complications
ispartof: Arthritis & Rheumatology, March 2016, Vol.68(3), pp.713-723
description: To determine the prevalence of lung abnormalities on chest computed tomography (CT) in patients with microscopic polyangiitis (MPA), to assess the responsiveness of such abnormalities to initial treatment, and to assess associations between these abnormalities and patient and disease characteristics and mortality. We retrospectively identified 167 consecutive hospital-based patients with MPA in 3 hospitals in Japan. We longitudinally collected clinical information for 150 of these patients, for whom CT images obtained before treatment were available. We then determined the presence of 22 imaging components of lung abnormalities in these patients. The vast majority of patients (97%) had at least 1 lung abnormality on chest CT images, including interstitial lung lesions (66%), airway lesions (66%), pleural lesions (53%), and emphysematous lesions (37%). In multivariate analyses, ground-glass opacity was associated with the Birmingham Vasculitis Activity Score, whereas 3 of 4 airway lesions were associated with myeloperoxidase-antineutrophil cytoplasmic antibodies. Latent class analysis identified a distinct group of patients with airway-predominant lung lesions. Airway lesions such as bronchiolitis and bronchovascular bundle thickening were among the components that showed improvement within 3 months of the initial treatment. An idiopathic pulmonary fibrosis pattern was the only chest CT variable that was independently associated with shorter survival. Abnormalities in a wide range of anatomic areas, including the whole airway, can be identified in the lungs of patients with MPA before treatment. The prevalence, clustering patterns, and responsiveness to treatment of individual lung abnormalities provide groundwork for informing future studies to understand the pathophysiology of MPA.
language:
source:
identifier: ISSN: 2326-5191 ; E-ISSN: 2326-5205 ; DOI: 10.1002/art.39475
fulltext: fulltext
issn:
  • 2326-5191
  • 23265191
  • 2326-5205
  • 23265205
url: Link


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titlePrevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients
creatorYamagata, Mieko ; Ikeda, Kei ; Tsushima, Kenji ; Iesato, Ken ; Abe, Mitsuhiro ; Ito, Takashi ; Kashiwakuma, Daisuke ; Kagami, Shin‐Ichiro ; Iwamoto, Itsuo ; Nakagomi, Daiki ; Sugiyama, Takao ; Maruyama, Yuichiro ; Furuta, Shunsuke ; Jayne, David ; Uno, Takashi ; Tatsumi, Koichiro ; Nakajima, Hiroshi
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subjectRadiography, Thoracic ; Tomography, X-Ray Computed ; Lung Diseases -- Diagnostic Imaging ; Microscopic Polyangiitis -- Complications;
descriptionTo determine the prevalence of lung abnormalities on chest computed tomography (CT) in patients with microscopic polyangiitis (MPA), to assess the responsiveness of such abnormalities to initial treatment, and to assess associations between these abnormalities and patient and disease characteristics and mortality. We retrospectively identified 167 consecutive hospital-based patients with MPA in 3 hospitals in Japan. We longitudinally collected clinical information for 150 of these patients, for whom CT images obtained before treatment were available. We then determined the presence of 22 imaging components of lung abnormalities in these patients. The vast majority of patients (97%) had at least 1 lung abnormality on chest CT images, including interstitial lung lesions (66%), airway lesions (66%), pleural lesions (53%), and emphysematous lesions (37%). In multivariate analyses, ground-glass opacity was associated with the Birmingham Vasculitis Activity Score, whereas 3 of 4 airway lesions were associated with myeloperoxidase-antineutrophil cytoplasmic antibodies. Latent class analysis identified a distinct group of patients with airway-predominant lung lesions. Airway lesions such as bronchiolitis and bronchovascular bundle thickening were among the components that showed improvement within 3 months of the initial treatment. An idiopathic pulmonary fibrosis pattern was the only chest CT variable that was independently associated with shorter survival. Abnormalities in a wide range of anatomic areas, including the whole airway, can be identified in the lungs of patients with MPA before treatment. The prevalence, clustering patterns, and responsiveness to treatment of individual lung abnormalities provide groundwork for informing future studies to understand the pathophysiology of MPA.
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titlePrevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients
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authorYamagata, Mieko ; Ikeda, Kei ; Tsushima, Kenji ; Iesato, Ken ; Abe, Mitsuhiro ; Ito, Takashi ; Kashiwakuma, Daisuke ; Kagami, Shin‐Ichiro ; Iwamoto, Itsuo ; Nakagomi, Daiki ; Sugiyama, Takao ; Maruyama, Yuichiro ; Furuta, Shunsuke ; Jayne, David ; Uno, Takashi ; Tatsumi, Koichiro ; Nakajima, Hiroshi
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atitlePrevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients
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