ABSTRACT
INTRODUCTION: The diagnosis of interstitial lung disease (ILD) requires elimination of underlying connective tissue disease. Consequently, antinuclear antibodies (ANA) are routinely screened in patients with idiopathic interstitial pneumonia. However the clinical usefulness of this practice is not well clear. AIM: In this study, we evaluated the frequency of ANA in ILD's patients and investigated the clinical significance of the ANA's presence in these patients. METHODS: We conducted a retrospective study of hospitalized patients diagnosed ILD at pulmonary department and for which ANA was performed in the immunology laboratory of our institution. Demographic features, clinical symptoms, biological and radiologic findings and CTD-ILD diagnoses were compared between patients with positive ANA versus negative ANA. RESULTS: We enrolled 73 patients. The ANA's prevalence was 32%. There were no significant differences in demographics, pulmonary function test values and radiologic findings between patients with and without ANA. Patients with positive ANA had more cutaneous manifestations (pê0.011) and Raynaud's phenomenon (pê0.029). The diagnosis of connective tissue disease was made in 42% of patients with positive ANA versus 8% with negative ANA (pê 0.001). ANA's titer higher than 1/320 was predictive of CTD diagnosis (ORê14.4) (p<0.001). CONCLUSIONS: The research of ANA in PID's patients is an important tool of CTD diagnosis specially in those with suggestive symptoms of autoimmune disease.
Subject(s)
Antibodies, Antinuclear/blood , Autoimmune Diseases/epidemiology , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/epidemiology , Autoimmune Diseases/blood , Autoimmune Diseases/complications , Autoimmune Diseases/diagnosis , Case-Control Studies , Connective Tissue Diseases/blood , Connective Tissue Diseases/diagnosis , Connective Tissue Diseases/epidemiology , Female , Hospitalization/statistics & numerical data , Humans , Idiopathic Pulmonary Fibrosis/blood , Idiopathic Pulmonary Fibrosis/diagnosis , Idiopathic Pulmonary Fibrosis/epidemiology , Lung Diseases, Interstitial/blood , Lung Diseases, Interstitial/therapy , Male , Prevalence , Prognosis , Raynaud Disease/blood , Raynaud Disease/diagnosis , Raynaud Disease/epidemiology , Respiratory Function Tests , Retrospective Studies , Seroepidemiologic Studies , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Several studies showed a correlation between C-reactive protein and mortality in spontaneous intracerebral hemorrhage. However, the best time to measure C-reactive protein to assess prognosis is not yet clear. The purpose of this study was to determine if initial or H24-C-reactive protein is independently associated with 30-day mortality in intracerebral hemorrhage. METHODS: This is a retrospective study done within years 2010-2015. All intracerebral hemorrhage cases with missing data or with autoimmune disease or neoplasm were excluded. Univariate and multivariate analyses were assessed for initial C-reactive protein, H24-C-reactive protein, and confounding factors. RESULTS: Of 122 patients, 91 were selected. Only H24-C-reactive protein, hematoma volume, and infratentorial origin were independently associated with 30-day mortality in intracerebral hemorrhage. When adjusted with intracerebral hemorrhage score, H24-C-reactive protein with a cutoff value of 30 mg/L independently predicted 30-day mortality. CONCLUSIONS: This study suggests that H24-C-reactive protein may be a more reliable marker than initial C-reactive protein in the prediction of mortality in intracerebral hemorrhage. A large multicentric study is necessary to confirm the interest of including H24-C-reactive protein to a modified intracerebral hemorrhage score for the prediction of 30-day mortality.
