Literature DB >> 23582575

FEV1 over time in patients with connective tissue disease-related bronchiolitis.

Evans R Fernández Pérez1, Mahalakshmi Krishnamoorthy, Kevin K Brown, Tristan J Huie, Aryeh Fischer, Joshua J Solomon, Richard T Meehan, Amy L Olson, Rosane Duarte Achcar, Jeffrey J Swigris.   

Abstract

BACKGROUND: Fibrosis or inflammation of the bronchioles is a well-known manifestation of connective tissue disease (CTD). However, the natural history of CTD-related bronchiolitis is largely unknown.
METHODS: We analyzed consecutive patients evaluated at National Jewish Health (Denver, CO) from 1998 to 2008 with CTD and surgical lung biopsy-confirmed bronchiolitis. Linear mixed effects models were used to estimate the longitudinal postbronchodilator FEV1 %predicted (%pred) course and differences between subjects with or without constrictive bronchiolitis (CB).
RESULTS: Of 28 subjects with a mean age of 53 ± 9 years, fourteen (50%) had CB. The most common CTD diagnosis was rheumatoid arthritis (n = 14; 50%). There were no significant differences in demographics, smoking status, underlying CTD diagnoses, 6-min walk distance, dyspnea score or drug therapy between subjects with CB and those with cellular bronchiolitis. Three subjects with CB (11%) and four with cellular bronchiolitis (14%) died. Compared with subjects with CB, those with cellular bronchiolitis had higher mean FEV1 %pred at all times. There were no significant differences in FEV1 %pred slope within- or between-groups (CB vs. cellular bronchiolitis) preceding surgical lung biopsy or afterward.
CONCLUSION: Subjects with CTD-related CB had lower FEV1 %pred values than those with CTD-related cellular bronchiolitis at all time points, but FEV1 %pred remained stable over time in both groups regardless of therapy received.
Copyright © 2013 Elsevier Ltd. All rights reserved.

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Year:  2013        PMID: 23582575      PMCID: PMC3697096          DOI: 10.1016/j.rmed.2013.02.019

Source DB:  PubMed          Journal:  Respir Med        ISSN: 0954-6111            Impact factor:   3.415


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