Clinical characteristics of pulmonary Mycobacterium avium complex disease in patients with interstitial lung disease.

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2024-09-06 DOI:10.1016/j.jiac.2024.09.004

Masayuki Watanabe, Eri Hagiwara, Ryota Shintani, Yuri Hiramatsu, Satoshi Ikeda, Ryo Okuda, Akimasa Sekine, Tomohisa Baba, Shigeru Komatsu, Takashi Ogura

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引用次数: 0

Abstract

Objective: Mycobacterium avium complex pulmonary disease (MAC-PD) is occasionally complicated by interstitial lung disease (ILD) in clinical practice, but clinical studies are limited. This study aims to elucidate the clinical and imaging characteristics of MAC-PD in patients with ILD.

Methods: We retrospectively analyzed imaging and clinical data from medical records of 54 consecutive ILD patients diagnosed with MAC-PD from 2011 to 2021 at our institution. We compared the imaging and clinical data of these patients with 2218 ILD patients diagnosed at our institution.

Results: The mean age of the patients was 74 years, with 25 males and 29 females, and a mean body mass index (BMI) of 20.0 kg/m². Compared to all ILD patients, ILD-associated MAC-PD had older ages, lower BMI. The most common underlying ILD diagnosis was unclassifiable interstitial pneumonia. MAC-PD imaging classification was nodular-bronchiectatic (NB) type in 17 patients, fibro-cavitary (FC) type in 15 patients, and unclassifiable (UC) type in 22 patients. Many UC types were difficult to diagnose due to the absence of clear findings indicative of MAC infection. Chronic pulmonary aspergillosis complication was 24.1 %. The mean survival of ILD-associated MAC-PD was 55.6 months, shorter than that of regular MAC-PD. The UC type had a shorter survival than the NB type, similar to the FC type.

Conclusion: MAC-PD associated with ILD frequently complicates chronic pulmonary aspergillosis and has a poor prognosis. The most common imaging type, UC type, particularly has a shorter survival. Careful management is essential for MAC-PD associated with ILD.

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间质性肺病患者肺分枝杆菌复合体疾病的临床特征。

目的：分枝杆菌复合肺病（MAC-PD）在临床实践中偶尔会并发间质性肺病（ILD），但临床研究有限。本研究旨在阐明复合分枝杆菌肺病（MAC-PD）在 ILD 患者中的临床和影像学特征：我们回顾性分析了本院 2011 年至 2021 年期间连续 54 例诊断为 MAC-PD 的 ILD 患者病历中的影像学和临床数据。我们将这些患者的影像学和临床数据与本院确诊的 2218 例 ILD 患者进行了比较：患者的平均年龄为 74 岁，其中男性 25 人，女性 29 人，平均体重指数 (BMI) 为 20.0 kg/m2。与所有 ILD 患者相比，ILD 相关的 MAC-PD 患者年龄较大，体重指数较低。最常见的基础 ILD 诊断是无法分类的间质性肺炎。17名患者的MAC-PD影像学分类为结节-支气管扩张（NB）型，15名患者的MAC-PD影像学分类为纤维空洞（FC）型，22名患者的MAC-PD影像学分类为不可分类（UC）型。由于缺乏明确的 MAC 感染指征，许多 UC 型患者难以诊断。慢性肺曲霉菌病并发症占 24.1%。与 ILD 相关的 MAC-PD 平均存活时间为 55.6 个月，短于普通 MAC-PD。UC型的存活期比NB型短，与FC型相似：结论：伴有ILD的MAC-PD常并发慢性肺曲霉菌病，且预后较差。结论：伴有 ILD 的 MAC-PD 常常并发慢性肺曲霉菌病，且预后较差，尤其是最常见的造影类型 UC 型，存活期更短。对于伴有 ILD 的 MAC-PD 患者，谨慎治疗至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.