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ABSTRACT: Undifferentiated connective tissue disease (UCTD) is a distinct clinical entity that may be accompanied by interstitial lung disease (ILD). The natural history of UCTD-ILD is unknown. We hypothesized that patients with UCTD-ILD would be more likely to have improvement in lung function than those with idiopathic pulmonary fibrosis (IPF) during longitudinal follow-up. We identified subjects enrolled in the UCSF ILD cohort study with a diagnosis of IPF or UCTD. The primary outcome compared the presence or absence of a > or = 5% increase in percent predicted forced vital capacity (FVC) in IPF and UCTD. Regression models were used to account for potential confounding variables. Ninety subjects were identified; 59 subjects (30 IPF, 29 UCTD) had longitudinal pulmonary function data for inclusion in the analysis. After accounting for baseline pulmonary function tests, treatment, and duration between studies, UCTD was associated with substantial improvement in FVC (odds ratio = 8.23, 95% confidence interval, 1.27-53.2; p = 0.03) during follow-up (median, 8 months) compared with IPF. Patients with UCTD-ILD are more likely to have improved pulmonary function during follow-up than those with IPF. These findings demonstrate the clinical importance of identifying UCTD in patients presenting with an "idiopathic" interstitial pneumonia.
Beiträge zur Klinik der Tuberkulose 04/2010; 188(2):143-9. · 1.90 Impact Factor
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ABSTRACT: Data examining the role of pulmonary rehabilitation (PR) in interstitial lung disease (ILD) are limited. We tested the hypothesis that PR can improve functional status and dyspnea in a large group of patients with ILD, and that certain baseline patient variables can predict this improvement.
Data from patients who were referred to PR with a diagnosis of ILD were included. Baseline and post-PR variables were recorded, and changes in 6-min walk test (6MWT) distance and dyspnea were evaluated. The impact of baseline variables on change in 6MWT distance and dyspnea were analyzed.
A statistically significant difference was seen in both the change in Borg score and 6MWT distance after PR (p < 0.0001). These changes were consistent with previously established clinically significant differences. Baseline 6MWT distance was a significant predictor of change in 6MWT distance (p < 0.0001), with increasing baseline 6MWT distance predicting a smaller improvement after PR.
These results suggest that PR should be considered as a standard of care for patients with ILD.
Chest 10/2008; 135(2):442-7. · 5.25 Impact Factor
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ABSTRACT: An association between exposure to Stachybotrys chartarum, a ubiquitous environmental mold, and respiratory disease in humans has been suggested but remains poorly defined [Hossain MA, Ahmed MS, Ghannoum, MA. Attributes of Stachybotrys chartarum and its association with human disease. J Allergy Clin Immunol 2004; 113: 200–08]. We report a patient who presented with acute respiratory failure and histopathological evidence of diffuse alveolar damage shortly after exposure to S. chartarum in her home.
Respiratory Medicine Extra 3(2):74-75.
