The Spectrum of Lung Disease due to Chronic Occult Aspiration

Cardasis, John; MacMahon, Heber; Husain, Aliya N.

doi:10.1513/annalsats.201310-360oc

Cited by 49 publications

(45 citation statements)

References 27 publications

(29 reference statements)

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“…For example, Cardasis et al reported 25 patients with a spectrum of pulmonary diseases resulting from chronic occult aspiration. 9 All but 1 (96%) had gastroesophageal reflux disease. The prevalence of …”

Section: Discussionmentioning

confidence: 99%

“…However, chronic occult aspiration of refluxed gastric contents in patients with gastroesophageal reflux disease may result in diffuse aspiration bronchiolitis, in which high-resolution CT of the chest typically reveals diffuse centrilobular nodules with tree-inbud opacities. 4,9,13 The distribution of pulmonary infiltrates in these patients is not limited to dependent (posterior and basal) regions of the lung, which have been traditionally associated with aspiration-related pulmonary manifestations. Lung masses seen in our 3 patients were also located in nondependent zones of the lung.…”

Section: Clinical Significancementioning

confidence: 99%

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Solitary Lung Masses Due to Occult Aspiration

Ryu

2015

The American Journal of Medicine

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Significancementioning

confidence: 99%

Solitary Lung Masses Due to Occult Aspiration

Ryu

2015

The American Journal of Medicine

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“…Importantly, many recent studies have shown that microaspiration following GERD can cause interstitial lung disease [19,20] , which is predominant in the right lung as observed in our cases [21] . In addition, GERD-related microaspiration has been reported to potentially cause upper lobe dominant interstitial lung disease [22] . Probably, restrictive thoracic movement in the operated side would also contribute to aggravate the impaired airway clearance following microaspiration.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Upper Lung Field Pulmonary Fibrosis Radiologically Consistent with Pleuroparenchymal Fibroelastosis after Thoracotomy: A New Disease Entity Related to Thoracotomy

Sekine

Satoh²,

Iwasawa³

et al. 2017

Respiration

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Background: Pleuroparenchymal fibroelastosis (PPFE) is a rare bilateral idiopathic interstitial pneumonia defined by pleural-parenchymal involvement. In clinical practice, we encountered patients with upper lung field pulmonary fibrosis (Upper-PF), which was radiologically consistent with PPFE, but apparently limited to the unilateral lung. Objectives: The purpose of the study was to clarify the clinical characteristics in those patients. Methods: We examined the medical records of all the consecutive patients from 2012 to 2016 to see whether there were patients having unilateral Upper-PF. Results: We found 6 patients with unilateral Upper-PF. The most common symptom was dyspnea, and all patients had a low body mass index and severe restrictive pulmonary impairment. Notably, all patients had a history of thoracotomy for resecting lung or esophageal cancer, and the lesions were limited to the operated side. Dynamic breathing chest MRI showed an impaired thoracic movement in the operated side. Serial chest CT from prethoracotomy to the first visit was obtained in 5 patients: before thoracotomy, only a slight apical cap, defined as a wedge- and triangle-shaped opacity with broad pleural contact, was observed only in the operated side, but progressed into the lesion after a median of 8.4 years following thoracotomy. After the first visit, the unilateral lesion rapidly deteriorated in all patients. Conclusions: Unilateral Upper-PF had some characteristics in common with PPFE. Because the lesion was limited to the operated side, unilateral Upper-PF would be a new disease entity related to thoracotomy. Our results indicate that thoracotomy impairs thoracic movement in the operated side and subsequently triggers unilateral Upper-PF development, especially in patients with an apical cap.

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“…particular demographic characteristics or comorbidities) to explain their discrepancies in IPF presentation, though we found no statistically significant evidence of this with respect to the factors we examined. Our findings imply that patients with asymmetric IPF cannot, at this time, be assumed to have alternative provocations of disease activity, such as increased tobacco use, radiation exposure, or aspiration events, which have links to the general IPF population [6,7,8,9,10]. Patients with asymmetric disease cannot be screened from a general IPF pool on the basis of gender or ethnicity, since a compelling segment of this group is constituted of white males – findings seen in the general IPF population [11].…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics in patients with asymmetric idiopathic pulmonary fibrosis

Callahan

Xia

Murray

et al. 2016

Respiratory Medicine

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Background A group of patients with idiopathic pulmonary fibrosis (IPF) present with disease affecting one lung markedly more than the other. At this time, it is unclear how this population differs from those who present with more symmetric disease. We sought to explain the characteristics of the asymmetric group and how their disease progresses. Methods In this retrospective case-control study we accessed an interstitial lung disease (ILD) database and identified 14 asymmetric IPF cases via high-resolution computed tomography (HRCT) scoring of each lung lobe’s disease severity. We identified 28 symmetric IPF controls from the same database using the same methods, and compared the clinical features of each group. Results Patients with asymmetric disease exhibited similar demographics as those in the general IPF population; they were predominantly male (64%), elderly (69 years old), and used tobacco (57%). We found a trend toward significantly increased all-cause mortality in the case population two years following diagnosis (p = 0.089). Pulmonary function tests were significantly lower in the case group at the time of diagnosis, then both groups experienced gradual decline. We found no statistically significant differences in number of IPF exacerbations (cases 43%, controls 39%, p = 0.824) and gastro-esophageal reflux (both groups 50%). Conclusion Patients with asymmetric IPF resemble patients in the general IPF population but may have a lower overall survival rate. Further systemic factors may be studied to identify reasons for disease asymmetry and clinical decline in this population.

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The Spectrum of Lung Disease due to Chronic Occult Aspiration

Abstract: In this study, chronic occult aspiration was associated with a number of comorbid conditions and a spectrum of radiologic and pathologic patterns, which in some patients included fibrosis.

Cited by 49 publications

References 27 publications

Solitary Lung Masses Due to Occult Aspiration

Solitary Lung Masses Due to Occult Aspiration

Unilateral Upper Lung Field Pulmonary Fibrosis Radiologically Consistent with Pleuroparenchymal Fibroelastosis after Thoracotomy: A New Disease Entity Related to Thoracotomy

Clinical characteristics in patients with asymmetric idiopathic pulmonary fibrosis

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