Idiopathic interstitial pneumonias

Ilkovich, Mikhail M.; Михайлович, Илькович Михаил; Novikova, Lubov; Николаевна, Новикова Любовь

doi:10.26442/00403660.2021.03.200660

Terapevticheskii arkhiv

2021

DOI: 10.26442/00403660.2021.03.200660

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Idiopathic interstitial pneumonias

Mikhail M. Ilkovich

Илькович Михаил Михайлович²,

Lubov Novikova

et al.

Abstract: The article presents the evolution of views on one of the current problems of present pulmonology idiopathic interstitial pneumonias. On the basis of many years of experience in diagnosis and treatment of patients of IIPs in the clinic of pulmonology of Interstitial and Orphan Lung Diseases Research Institute of Pavlov First Saint Petersburg State Medical University, the authors formulated a new understanding of this pathology and proposed to unite all IIPs under the term idiopathic fibrosing pulmonary diseas… Show more

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Cited by 3 publications

References 13 publications

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Interstitial lung diseases in persons infected with human immunodeficiency virus

Korzh

2023

Pulʹmonologiâ (Mosk.)

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Diagnosis of interstitial lung diseases (ILD) in individuals infected with the human immunodeficiency virus (HIV) remains poorly understood.The purpose of the work was to demonstrate approaches to the diagnosis of ILD in HIV-infected patients with different levels of CD4 lymphocytes. An analysis of literature data and clinical observations of ILD in HIV-infected individuals (n = 2) whose CD4 lymphocyte count was 677 (37.5%) and 1 (0.21%) cells/μl are presented. The patients were observed and treated for a long time by pulmonology specialists, including anti-tuberculosis chemotherapy. The patient with CD4 lymphocyte count of 677 cells/μl in the absence of Mycobacterium tuberculosis in the sputum had an established diagnosis of idiopathic pulmonary fibrosis with the progressive development of respiratory failure and progression of the computed tomographic pattern from large areas of “ground glass” to the formation of reticular changes and “honeycomb” lung within 2 years. The patient with CD4 count of 1 cell/μl was diagnosed with nonspecific interstitial pneumonia based on characteristic clinical manifestations of increasing respiratory failure against the background of diffuse interstitial pneumofibrosis in the absence of bacterial excretion, the effects of antimycobacterial, antibacterial and antifungal treatment for 7 months, and excluding other causes of lung damage.Conclusion. The development of interstitial fibrosing pulmonary process of non-infectious etiology in HIV-infected patients with different states of T-helper immunity has been demonstrated. After excluding opportunistic infections, the influence of other factors, and concomitant diseases, these patients were diagnosed with various forms of idiopathic interstitial pneumonia. However, existing reports of the direct damaging effects of the virus on the pulmonary parenchyma also suggest the possibility of HIV-associated interstitial pulmonary fibrosis.

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Interstitial lung diseases in persons infected with human immunodeficiency virus

Korzh

2023

Pulʹmonologiâ (Mosk.)

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Possibilities for predicting the course of fibrosing interstitial lung diseases based on a comprehensive study of the cardio-respiratory system

Obukhova,

Kulikov,

Rabik

et al. 2024

Regional blood circulation and microcirculation

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Introduction. The problem of predicting the course of fibrosing interstitial lung diseases (FILD) is extremely relevant for the timely initiation of the treatment. Aim. To build a prognostic model based on data from a comprehensive study of the cardiorespiratory system in patients with FILD. Material and methods. The study included a group of 40 patients: 18 men and 22 women (M±S 60±9.7 years old), with verified FILD, who completed a full range of clinical and instrumental studies of the cardiorespiratory system at the time of inclusion in the study and after 12 months of observation. Then the initial group was divided into 2 groups: group A (20 patients), which did not reach the combined point, and group B (20 patients), which reached the combined point after 12 months. The combined point consisted of several outcomes: an increase in the degree of dyspnea on the m-MRC scale to 4 points, a deterioration in the results of the 6-minute walk test ≥50 m, a decrease in FVC or TLC ≥10 %, a decrease in the diffusing capacity of the lung for carbon monoxide (DLСO) ≥15 %, the lung transplantation, a death due to the lung disease. Results. Groups A and B did not have any differences in gender, age (А group (M±S) 57±11.8 y. o.; B group (M±S) 63±7.6 y. o., (p=0.06)), structure of the FILD nosology, the therapy and the frequency of the antifibrotic drug prescription. The hard endpoint at 12 months was achieved in 20 of 40 patients (50 %). Patients who reached the combined point were characterized by initially lower lung volumes (VC(M±S) 2.09±0.56 (p=0.016)); FVC (M±S) 1.99±0.55 (p=0.029)), FEV1 (M±S) 1.67±0.37 (p=0.036)), according to the results of a comprehensive study of the pulmonary function; a higher oxygen desaturation index (ODI (M±S) 5.76±4.48 (p=0.022)) and a more pronounced decrease in nocturnal saturation according to the computer pulse oximetry and the cardiorespiratory monitoring (SpO2 (M±S) 81.01±6.74 (p<0.029)). We developed a prognostic model that included such indicators as: post-bronchodilator MOC 75, TAPSE, VE/VCO2 (VO2 peak), desaturation index and minimum SPO2 % (AUC=0.949). Conclusion. The developed prognostic model for the course of FILD, based on the data from the comprehensive study of the cardiorespiratory system, demonstrated high sensitivity (93.8 %) and specificity (87.5 %).

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Progressive fibrosing lung disease. Discussion aspects of the problem: A review

Ilkovich

Novikova

Speranskaya

et al. 2023

Terapevticheskii arkhiv

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Abstract The authors of the article prove the need to include a new name for the disease "Progressive Fibrosing Lung Disease" into clinical practice. Recognition of the fact that some lung diseases end in a fibrosing process, which does not have any significant differences depending on the initial disease that led to fibrosis, will expand the indications for earlier prescription of antifibrotic drugs, which will undoubtedly improve the prognosis in this extremely severe category of patients.

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Idiopathic interstitial pneumonias

Cited by 3 publications

References 13 publications

Interstitial lung diseases in persons infected with human immunodeficiency virus

Interstitial lung diseases in persons infected with human immunodeficiency virus

Possibilities for predicting the course of fibrosing interstitial lung diseases based on a comprehensive study of the cardio-respiratory system

Progressive fibrosing lung disease. Discussion aspects of the problem: A review

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