EARLY DIAGNOSIS OF INTERSTITIAL LUNG DISEASE WITHOUT OPEN LUNG BIOPSY
Keywords:Interstitial Lung Disease, Diagnosis, Clinical Methods
Objective : The primary objective of this study was to diagnose interstitial lung disease in patients with thorough clinical history, physical exam, chest radiograph, high resolution CT scan, pulmonary function tests (without open lung biopsy) for early diagnosis of disease and to reduce the progression of disease.
Design: This was a Cross sectional study, patients of ILD were selected and studied during the period from November 2017 - December2018)
Setting: Department of Pulmonary Medicine, Shadan Institute of Medical Sciences
Duration: One year (patients of ILD were selected and studied during the period from November 2017 - December2018)
Participants: 69 Patients with ILD attending department of Pulmonary Medicine, Shadan Institute of Medical Sciences. Hyderabad, Telangana.
Methods: Patients with ILD were included in the study. Radiologic, spirometric evaluation was done and the results are statistically analyzed.
Results: Most common form ILD observed was IPF (37.2%) and collagen vascular disease (5.1%). Majority of cases belonged to the age groups 41-50yrs (26%) and 51 -60 yrs (26%). Most of the cases were males (63.7%) and dyspnoea (100%) on exertion and cough (97%) were the most common presenting features. In reference to radiological abnormalities most common pattern observed is honey combing (45.8%) and ground glass (15.2%) & reticular in (13.5%) of patients. 63.6% of cases of IPF and 33 % of RA-ILD showed honey combing features. Associated features like shaggy cardiac borders, elevated domes of diaphragm and lymphadenopathy, pleural reaction were observed in 42.4% of patients. The Zonal distribution of the disease on chest X-ray showed that (6.8%) of patients involve mid and lower zones. Only lower zones were involved in 23.7 % subjects and mid-zone in 1.7%. Involvement of all zones was observed in 64.4 % of cases. Spiro metric function was observed in subjects. Restrictive defect was observed in 81.3 % of patients and mixed defect was observed in 18.6 % patients.
Conclusion: HRCT is significantly superior to chest radiography in identifying and determining the correct diagnosis of ILD. A confident clinical diagnosis of IPF can be reliably made in the presence of characteristic HRCT and clinical findings. However small subset of young patients who are progressing the disease with rapid deterioration may require invasive tests like trans bronchial lung biopsy to rule out infective process or malignancy
Keywords: Interstitial Lung Disease, Diagnosis, Clinical Methods.