Clinical, radiological and evolutionary aspects of non-specific interstitial Pneumonia
Department of Radiology and interventional Imaging, Hassan II University Hospital, Fez, Morocco.
Research Article
World Journal of Advanced Research and Reviews, 2023, 19(02), 872–883
Article DOI: 10.30574/wjarr.2023.19.2.1630
Publication history:
Received on 12 July 2023; revised on 20 August 2023; accepted on 22 August 2023
Abstract:
Introduction: Non-specific interstitial pneumonia (NSIP) is an interstitial lung disease that may be idiopathic or secondary to connective tissue disease, toxins or numerous other causes.
Materials and methods: This is a retrospective study of 30 cases of non-specific interstitial lung disease collected in the radiology and pneumology departments of the Hassan II University Hospital of Fez, spread over a period of 4 years.
Results: We collected 30 cases followed for NSIP. The mean age was 49.5 years, with extremes ranging from 26 to 70 years. A clear female predominance was noted (83%). Smoking intoxication was found in 13% of cases. Clinical symptoms were dominated by dyspnea in 26 cases, cough in 19 patients, chest pain in 4 cases and fever in only 1 patient. A restrictive ventilatory disorder was present in 87% of cases.
The radiological appearance was in favor of cellular NSIP in 10 patients and fibrosing NSIP in 20 cases. Elemental scanographic lesions were dominated by intralobular reticulations in 97% of cases, presence of ground glass in 83% of cases, bronchiectasis in 87% and septal lines in 80% of cases. Honeycomb and micronodules were present in 20%. Abnormalities were bilateral with basal topography predominant in 26 cases (87%). Lung biopsy was performed in 4 patients. NSIP was idiopathic in 11 cases and associated with a connective tissue disease in 19 cases. The etiologies were dominated by systemic scleroderma found in 11 cases, followed by anti-synthetase syndrome (4 cases), rheumatoid arthritis (3 cases), Gougerot Sjogren's syndrome (2 cases), systemic lupus erythematosus (1 case). Systemic corticosteroid therapy was prescribed in 26 patients and immunosuppressants in second intention in 21 cases, 4 patients were lost to follow-up and did not receive treatment. The evolution under treatment was marked by a clear clinical improvement in 14 patients, a stability in 8 patients and an aggravation in 4 patients.
Conclusion: The final diagnosis of NSIP relies on a multidisciplinary discussion between clinicians, radiologists and expert pathologists; it is essential to make the differential diagnosis with UIP as the majority of patients with NSIP have a better prognosis and respond well to corticosteroid treatment.
Keywords:
Nonspecific Interstitial Pneumonia; Chest CT; Usual Interstitial Pneumonia; Connective Tissue Disease; Lung; Evolution.
Full text article in PDF:
Copyright information:
Copyright © 2023 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0