Idiopathic pulmonary fibrosis (With 12 cases)

Akın KAYA, Özgür KARACAN, Numan NUMANOĞLU, Ramazan İDİLMAN, İsmail SAVAŞ, Peri ARBAK

Abstract

Twelve cases of idiopathic pulmonary fibrosis who had been hospitalized in our chest department evaluated for diagnostic and therapeutic management, retrospectively. Mean age was 61.4 ± 14.3 and male/female ratio was equal. Reticular pattern was observed on %41.7 of cases, reticulonodular pattern was observed on %16.6 of cases and honey-combing presented on %41.7 of cases on high-resolution computed tomography. Pulmonary function tests showed reticular pattern. While DLCO was %59.1 ± 32.9 (mean % predictive level), mean P (A-a) O2 was found as 36.2 ± 18.3. Open lung biopsy was used for one patient as a diagnostic approach, transbronchial biopsy was chosen for 5 patients. EBV IgG was found positive on 3 cases, four patients had positive results for CMV IgG, and two patients had positive results for CMV IgM, steroids were the first choise for treatment of %58.4 of the cases. Symptomatic therapy was used for three cases (%25), clinical course wasn't observed on eight of patients (%66.7). Three patients died (%25.6). Results were discussed.

Özet

Kliniğimizde izlenen 12 İPF (İdiopatik Pulmoner Fibrozis) olgusu tanı ve tedavi yaklaşımı açısından retrospektif olarak değerlendirildi. Olguların yaş ortalaması 61.4 ± 14.3 ve erkek/kadın oranı bir idi. Yüksek rezolüsyonlu bilgisayarlı tomografi (YRBT) bulguları; 5 olguda (%41.7) interlobüler septal kalınlaşma; 2 olguda (%16.6) retikülonodüler patern, 5 olguda (%41.7) bal peteği paterni gözlendi. Solunum fonksiyon testlerinde restriktif patern gözlenirken, ortalama DLCO (% beklenen değer) %59.1 ± 32.9, alveolo-arteriyoler gradient ortalama 36.2 ± 18.3 bulundu. Tanı amaçlı bir olguya açık akciğer biyopsisi uygulanırken, 5 olguya TBAB uygulanmıştı. Üç hastada (%25) EBV IqG (+), 4 hastada (%33.3) CMV IgG (+), 2 hastada (%16.6) CMV IgM (+) bulundu. Tedavide steroidler ilk sırada yer alırken (%58.4), semptomatik tedavi (%25) ikinci sıradaydı. Serimizde yer alan 8 hastanın (%66.7) klinik seyrinin izlenemediği, 3 hastanın (%25.6) öldüğü gözlendi. Bulgular literatür bilgileri ile karşılaştırıldı.