Usual interstitial pneumonia: typical, possible, and “inconsistent” patterns

Torres, Pedro Paulo Teixeira e Silva; Rabahi, Marcelo Fouad; Moreira, Maria Auxiliadora Carmo; Meirelles, Gustavo de Souza Portes; Marchiori, Edson

doi:10.1590/s1806-37562016000000368

Cited by 5 publications

(9 citation statements)

References 29 publications

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“…In AR patients with lung involvement, the radiological UIP pattern is not only the most frequent one (about 60–70%) but also the most associated with poor prognosis [ 1 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Tofacitinib for the Treatment of Severe Interstitial Lung Disease Related to Rheumatoid Arthritis

Vacchi

Manfredi

Cassone

et al. 2021

Case Reports in Medicine

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Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by chronic symmetrical erosive synovitis and extra-articular manifestations, including interstitial lung disease (ILD), whose treatment is nowadays challenging due to high infectious risk and possible pulmonary iatrogenic toxicity. Janus kinase inhibitors, namely, tofacitinib, baricitinib, and upadacitinib, are the latest drug class for the treatment of RA with a good safety profile. We present the case of a patient with RA-ILD successfully treated with tofacitinib. A 52-year-old man was referred to our multidisciplinary clinic for rheumatic and pulmonary diseases for an active erosive seropositive RA and progressive ILD. Previous treatments were GC, hydroxychloroquine, methotrexate, etanercept, withdrawn after ILD detection, and tocilizumab, discontinued due to relapsing infections. After our evaluation, we proposed rituximab in addition to low-dose GC and hydroxychloroquine, ineffective on joint involvement. Therefore, we proposed tofacitinib which allowed us to control joint involvement, stabilize ILD improving respiratory symptoms, and manage the frequent infectious episodes that occurred initially. The short half-life and rapid-acting of tofacitinib are two helpful characteristics regarding this aspect. Despite limited data from randomized trials and real-life, tofacitinib could represent a safe therapeutic option for RA-ILD patients. Longitudinal studies are required to confirm this encouraging report.

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“…In AR patients with lung involvement, the radiological UIP pattern is not only the most frequent one (about 60–70%) but also the most associated with poor prognosis [ 1 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Tofacitinib for the Treatment of Severe Interstitial Lung Disease Related to Rheumatoid Arthritis

Vacchi

Manfredi

Cassone

et al. 2021

Case Reports in Medicine

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“…DOI: 10.1117/12.2512866 Table (1) Radiological CT findings for Usual Interstitial Pneumonia (UIP), Non-Specific Interstitial Pneumonia (NSIP) and Chronic Hypersensitivity Pneumonitis (CHP). [1][2][3][4] Typical UIP Typical NSIP Typical CHP Peripheral, Basal.…”

Section: Introductionmentioning

confidence: 99%

A lung graph model for the classification of interstitial lung diseases on CT images

Vanoost

Cid

Rubin

et al. 2019

Medical Imaging 2019: Computer-Aided Diagnosis

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Diagnosing Interstitial Lung Diseases (ILD) is a difficult task. It requires experienced chest radiologists that may not be available in less-specialized health centers. Moreover, a correct diagnosis is needed to decide for an appropriate treatment and prognostic. In this paper, we focus on the classification of 3 common subtypes of ILDs: Usual Interstitial Pneumonia (UIP), Non-Specific Interstitial Pneumonia (NSIP) and Chronic Hypersensitivity Pneumonitis (CHP). We propose a graph model of the lungs built from a large dataset. The structure of the graph is inspired from medical knowledge of disease predominance, where the nodes correspond to 24 distinct regions obtained from lateral, anterior-posterior and vertical splits of the images. The adjacency matrix is built from distances between intensity distributions of distinct regions. Graphs models are interpretable and were successfully used in neuroimaging. However, to the best of our knowledge, this is the first attempt to use a graph model of the lungs for classifying ILDs. In the particular case of ILDs, graph methods are relevant for the following reasons. In order to differentiate between the subtypes, not only the types of local patterns of the disease are important but also their anatomical location. Therefore, we hypothesize that the comparison between regional distributions of Hounsfield Unit (HU) values is relevant to discriminate between the considered ILD subtypes. For instance, typical UIP shows a spatial predominance of reticular abnormalities and honeycombing in the peripheral regions of the lung bases. Therefore, we expect a marked difference of HU distributions between the central and peripheral regions of the lung bases. Moreover, the construction of the graph leads to an interpretable patient descriptor. The descriptor led to encouraging area under the Receiver Operating Characteristic (ROC) curve in 0.6-0.8 for one-versus-one classification configurations, which also showed to outperform feature sets based on a simple concatenation of regional HU distributions.

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“…The current issue of the JBP presents a pictorial essay that discusses, in a quite didactic manner, all of the certainties and inconsistencies that involve the diagnosis of usual interstitial pneumonia, the most prevalent form of idiopathic interstitial lung disease. 11 …”

mentioning

confidence: 99%

“…A presente edição do JBP traz um ensaio pictórico que discute, de forma bastante didática, todas as certezas e inconsistências que envolvem o diagnóstico da pneumonia intersticial usual, a forma mais prevalente das doenças intersticiais pulmonares idiopáticas. 11 …”

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Momentum

Souza

2017

J. bras. pneumol.

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Usual interstitial pneumonia: typical, possible, and “inconsistent” patterns

Cited by 5 publications

References 29 publications

Tofacitinib for the Treatment of Severe Interstitial Lung Disease Related to Rheumatoid Arthritis

Tofacitinib for the Treatment of Severe Interstitial Lung Disease Related to Rheumatoid Arthritis

A lung graph model for the classification of interstitial lung diseases on CT images

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