Predictors of radiological aggravations of pulmonary MAC disease

Abstract

Background and objectives The number of patients with pulmonary Mycobacterium avium complex (MAC) disease is increasing worldwide, especially among middle-aged women and never-smokers. However, little is known about the factors causing exacerbations of pulmonary MAC disease in untreated patients. The aim of the present study was to identify the predictors of radiological aggravations of pulmonary MAC disease. Methods From April 2011 to December 2018, 238 MAC patients at our institute were newly diagnosed with pulmonary MAC disease according to the 2007 American Thoracic Society/Infectious Disease Society guideline. Their medical records were examined retrospectively for their clinical findings. The radiological findings at the time of the diagnosis and 1 year later were evaluated. To identify the predictors of radiological aggravation, multivariable analysis was performed with the data of 167 treatment-naïve patients. Results Female, never-smoker, and nodular/bronchiectatic (NB) type were predominant in patients with pulmonary MAC disease. Univariate analysis of data from treatment-naïve subjects showed that no lung diseases other than MAC, extensive radiological findings, and a positive acid-fast bacilli (AFB) smear were significantly associated with radiological aggravations. On multivariate analysis, the radiological factor (larger affected area) and absence of other lung disease were significantly associated with radiological aggravations. In particular, the presence of abnormal shadows in more than 3 lobes was significantly associated with radiological aggravations. Conclusions In this study, the presence of extensive radiological findings and the absence of lung diseases other than MAC were predictors of radiological aggravations of treatment-naïve

Association between serum anti-glycopeptidolipid-core IgA antibody titers and clinical characteristics of Mycobacterium avium complex pulmonary disease

“…Thus, a strong positive anti-GPL-core IgA antibody result was associated with high radiological scores for infiltration but not for cavitary lesions. This result is in accordance with those of previous studies reporting that the anti-GPL-core IgA antibody titer level was not related to the extent of fibrocavitary disease phenotype (Kitada et al, 2008) and that fibrocavitary disease phenotype and cavitary lesions were not correlated with the MAC-PD progression (Kodaka et al, 2020).…”

“…High-resolution chest CT findings were classified as either showing or not showing a cavitary lesion. Additionally, chest CT findings at the time of initial diagnosis were scored, as previously described (Kodaka et al, 2020). Briefly, the lung fields were divided into six lobes based on anatomical structures: right upper, right middle, right lower, left upper (S1+2 and S3), left lingular (S4 and S5), and left lower lobes.…”

Association between Serum Anti-glycopeptidolipid-core IgA Antibody Titers and Clinical Characteristics of Mycobacterium Avium Complex Pulmonary Disease

“…High-resolution chest CT ndings were classi ed as either showing or not showing a cavitary lesion. Additionally, chest CT ndings at the time of initial diagnosis were scored, as previously described [33]. Brie y, the lung elds were divided into six lobes based on anatomical structures: right upper, right middle, right lower, left upper (S1+2 and S3), left lingular (S4 and S5), and left lower lobes.…”

Exacerbating factors in elderly patients with Mycobacterium avium complex pulmonary disease

“…The lung fields were divided into six lobes based on anatomical structures: right upper; right middle; right lower; left upper (S1 + 2 and S3); left lingular (S4 and S5) and left lower. We assessed whether, at the time of diagnosis, each lung lobe had a shadow such as cavities, bronchiectasis, small nodules, consolidations or atelectasis (maximum six lobes) [ 15 ].…”