PMID- 28467213
OWN - NLM
STAT- MEDLINE
DCOM- 20170918
LR  - 20220330
IS  - 1543-2165 (Electronic)
IS  - 0003-9985 (Print)
IS  - 0003-9985 (Linking)
VI  - 141
IP  - 7
DP  - 2017 Jul
TI  - Interstitial Pneumonia With Autoimmune Features: Value of Histopathology.
PG  - 960-969
LID - 10.5858/arpa.2016-0427-OA [doi]
AB  - CONTEXT: - Patients with idiopathic interstitial pneumonia may display evidence 
      of autoimmunity without meeting criteria for a defined connective tissue disease. 
      A recent European Respiratory Society/American Thoracic Society statement 
      proposed research criteria for interstitial pneumonia with autoimmune features 
      (IPAF), which includes findings from the clinical, serologic, and morphologic 
      domains. OBJECTIVES: - To investigate the importance of histopathologic criteria 
      within the morphologic domain and to report our methodology for identifying these 
      features. DESIGN: - Patients with idiopathic interstitial pneumonia at the 
      University of Chicago who underwent surgical lung biopsy or lung transplantation 
      were assessed for IPAF histopathologic features, using the initial pathology 
      interpretation in the electronic records. A focused rereview of available slides 
      by a pulmonary pathologist was then performed for patients who failed to meet 
      IPAF criteria on initial pathology assessment. RESULTS: - Of 422 patients with 
      idiopathic interstitial pneumonia, 176 (41.7%) underwent surgical lung biopsy or 
      lung transplant. Forty-six of those 176 patients (26.1%) met IPAF criteria by 
      initial pathology interpretation and a positive clinical or serologic feature. Of 
      the remaining 130 patients, 73 (56.2%) met either the clinical or serologic 
      domains without meeting the morphologic domain, whereas 36 (27.7%) had slides 
      available for pathology rereview. This rereview demonstrated nonspecific 
      interstitial pneumonia in 8 of 36 patients (22.2%) and lymphoplasmacytic 
      infiltrates in 6 of 36 patients (16.7%), resulting in an additional 7 of 36 
      patients (19.4%) with idiopathic interstitial pneumonia that met the IPAF 
      criteria. In IPAF, pulmonary vasculopathy was the most prevalent finding (45 of 
      84; 53.6%) and predicted increased mortality (hazard ratio, 2.5; P = .04). 
      CONCLUSIONS: - Using a methodological approach to identifying IPAF pathology, we 
      demonstrate a significant increase in the number of patients meeting IPAF 
      criteria because of focused pathologic review and highlight the prognostic value 
      of the IPAF pathologic findings.
FAU - Adegunsoye, Ayodeji
AU  - Adegunsoye A
FAU - Oldham, Justin M
AU  - Oldham JM
FAU - Valenzi, Eleanor
AU  - Valenzi E
FAU - Lee, Cathryn
AU  - Lee C
FAU - Witt, Leah J
AU  - Witt LJ
FAU - Chen, Lena
AU  - Chen L
FAU - Montner, Steven
AU  - Montner S
FAU - Chung, Jonathan H
AU  - Chung JH
FAU - Noth, Imre
AU  - Noth I
FAU - Vij, Rekha
AU  - Vij R
FAU - Strek, Mary E
AU  - Strek ME
FAU - Husain, Aliya N
AU  - Husain AN
AD  - From the Section of Pulmonary and Critical Care Medicine, Department of Medicine 
      (Drs Adegunsoye, Witt, Noth, Vij, and Strek and Ms Chen) and the Departments of 
      Medicine (Drs Valenzi and Lee), Radiology (Drs Montner and Chung), and Pathology 
      (Dr Husain), University of Chicago, Chicago, Illinois; and the Division of 
      Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University 
      of California, Davis (Dr Oldham). Drs Adegunsoye and Oldham contributed equally 
      to this article.
LA  - eng
GR  - T32 HL007605/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20170503
PL  - United States
TA  - Arch Pathol Lab Med
JT  - Archives of pathology & laboratory medicine
JID - 7607091
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Autoimmunity
MH  - Female
MH  - Humans
MH  - Idiopathic Interstitial Pneumonias/*diagnosis
MH  - Male
MH  - Middle Aged
MH  - Pathology, Clinical/*methods
PMC - PMC5554445
MID - NIHMS889572
COIS- The authors have no relevant financial interest in the products or companies 
      described in this article.
EDAT- 2017/05/04 06:00
MHDA- 2017/09/19 06:00
PMCR- 2018/07/01
CRDT- 2017/05/04 06:00
PHST- 2017/05/04 06:00 [pubmed]
PHST- 2017/09/19 06:00 [medline]
PHST- 2017/05/04 06:00 [entrez]
PHST- 2018/07/01 00:00 [pmc-release]
AID - 10.5858/arpa.2016-0427-OA [doi]
PST - ppublish
SO  - Arch Pathol Lab Med. 2017 Jul;141(7):960-969. doi: 10.5858/arpa.2016-0427-OA. 
      Epub 2017 May 3.