A R Gibbs

Publications (2)9.26 Total impact

• Article: Alveolar proteinosis with hypersensitivity pneumonitis: a new clinical phenotype.

  Hema Verma, Andrew G Nicholson, Keith M Kerr, Owen J Dempsey, Allen R Gibbs, Ian Campbell, Fiona Black, Doris Rassl, Alexandra J Rice, Elizabeth A Renzoni, Athol U Wells, David M Hansell
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  ABSTRACT: The aim of the present study was to report the features of five patients with concurrent histopathological features of pulmonary alveolar proteinosis (PAP) and hypersensitivity pneumonitis (HP) and their high-resolution CT (HRCT) appearances. Patients with histopathological features of both HP and PAP on surgical lung biopsy referred for tertiary review were retrospectively identified. The pathology and HRCT images were semi-quantitatively scored to evaluate the relative contribution to HP and PAP. Five patients had histopathological features of HP and PAP but had varied HRCT appearances. All had imaging features of PAP to a varying degree with two patients also showing characteristics of HP but three patients had ill-defined thickened interlobular septa, not typical of either disease. We describe the coexistence of PAP and HP in five patients and discuss possible linkages between these two distinct pathologies.
  Respirology 08/2010; 15(8):1197-202. · 2.42 Impact Factor
• Source

  Available from: nih.gov

  Article: Inter-observer variation between pathologists in diffuse parenchymal lung disease.

  A G Nicholson, B J Addis, H Bharucha, C A Clelland, B Corrin, A R Gibbs, P S Hasleton, K M Kerr, N B N Ibrahim, S Stewart, W A H Wallace, A U Wells
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  ABSTRACT: There have been few inter-observer studies of diffuse parenchymal lung disease (DPLD), but the recent ATS/ERS consensus classification provides a basis for such a study. A method for categorising numerically the percentage likelihood of these differential diagnoses was developed, and the diagnostic confidence of pathologists using this classification and the reproducibility of their diagnoses were assessed. The overall kappa coefficient of agreement for the first choice diagnosis was 0.38 (n = 133 biopsies), increasing to 0.43 for patients (n = 83) with multiple biopsies. Weighted kappa coefficients of agreement, quantifying the level of probability of individual diagnoses, were moderate to good (mean 0.58, range 0.40-0.75). However, in 18% of biopsy specimens the diagnosis was given with low confidence. Over 50% of inter-observer variation related to the diagnosis of non-specific interstitial pneumonia and, in particular, its distinction from usual interstitial pneumonia. These results show that the ATS/ERS classification can be applied reproducibly by pathologists who evaluate DPLD routinely, and support the practice of taking multiple biopsy specimens.
  Thorax 07/2004; 59(6):500-5. · 6.84 Impact Factor