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Interstitial Lung Disease Among Patients with Giant Cell Arteritis
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A1686 - Interstitial Lung Disease Among Patients with Giant Cell Arteritis
Author Block: T. Jinta, H. Tamaki, M. Okada, R. Imai, H. Kanemura, K. Ishii, R. Tsugitomi, K. Okafuji, A. Kitamura, Y. Tomishima, N. Nishimura, T. Tamura; St Lukes International Hospital, Tokyo, Japan.
Background: Lately interstitial lung disease (ILD) has been recognized more and more as a manifestation of primary systemic vasculitis, particularly among patients with microscopic polyangiitis (MPA), which is predominantly a disease of the elderly in Japan. Another primary systemic vasculitis that occurs frequently in the elderly is Giant Cell Arteritis (GCA) and one of the unusual manifestations of GCA includes non-productive cough that can occur in about 10% of patients. It is speculated that vasculitis in the area of cough receptors results in this manifestation. There have been only anecdotes about the association of GCA with ILD and it is unknown whether ILD is truly prevalent in patients with GCA. Here we systematically reviewed chest images of patients with GCA and investigated the prevalence of CT scan abnormality consistent with ILD among patients with GCA. Method: Single center retrospective chart review was conducted at St. Luke’s International Hospital in Tokyo. The charts of patients with the diagnosis of GCA who were seen from March 2004 till August 2017 were extracted. The clinical data were obtained. Pulmonary images were reviewed by one of the authors, who is a pulmonologist and characteristics of the pulmonary lesions based on computed tomography (CT) of the lung were recorded. Results: Forty-six patients had a diagnosis of Giant Cell Arteritis. Thirty-nine of them had a chest CT scan. The mean age of the patients was 69 ± 17 years and 27 patients (58%) were female. Ten patients (26%) had abnormality in the CT scan. The abnormality included linear infiltrates beneath the posterior aspect of the pleura in the lung bases (n=9), ground glass opacities (n=3), honeycombing (n=3), and reticulonocular infiltrates (n=2). Two patients received prednisolone for ILD, ILD of whom were stable. No patients died during the median follow up of 14.5 months. Conclusion Chest CT abnormality consistent with mild ILD was prevalent among patients with GCA. The prognosis of these patients appears to be favorable and these patients responded to prednisolone.
Author Block: T. Jinta, H. Tamaki, M. Okada, R. Imai, H. Kanemura, K. Ishii, R. Tsugitomi, K. Okafuji, A. Kitamura, Y. Tomishima, N. Nishimura, T. Tamura; St Lukes International Hospital, Tokyo, Japan.
Background: Lately interstitial lung disease (ILD) has been recognized more and more as a manifestation of primary systemic vasculitis, particularly among patients with microscopic polyangiitis (MPA), which is predominantly a disease of the elderly in Japan. Another primary systemic vasculitis that occurs frequently in the elderly is Giant Cell Arteritis (GCA) and one of the unusual manifestations of GCA includes non-productive cough that can occur in about 10% of patients. It is speculated that vasculitis in the area of cough receptors results in this manifestation. There have been only anecdotes about the association of GCA with ILD and it is unknown whether ILD is truly prevalent in patients with GCA. Here we systematically reviewed chest images of patients with GCA and investigated the prevalence of CT scan abnormality consistent with ILD among patients with GCA. Method: Single center retrospective chart review was conducted at St. Luke’s International Hospital in Tokyo. The charts of patients with the diagnosis of GCA who were seen from March 2004 till August 2017 were extracted. The clinical data were obtained. Pulmonary images were reviewed by one of the authors, who is a pulmonologist and characteristics of the pulmonary lesions based on computed tomography (CT) of the lung were recorded. Results: Forty-six patients had a diagnosis of Giant Cell Arteritis. Thirty-nine of them had a chest CT scan. The mean age of the patients was 69 ± 17 years and 27 patients (58%) were female. Ten patients (26%) had abnormality in the CT scan. The abnormality included linear infiltrates beneath the posterior aspect of the pleura in the lung bases (n=9), ground glass opacities (n=3), honeycombing (n=3), and reticulonocular infiltrates (n=2). Two patients received prednisolone for ILD, ILD of whom were stable. No patients died during the median follow up of 14.5 months. Conclusion Chest CT abnormality consistent with mild ILD was prevalent among patients with GCA. The prognosis of these patients appears to be favorable and these patients responded to prednisolone.
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