Radiologic and pathologic characteristics of myeloperoxidase-antineutrophil cytoplasmic antibody–associated interstitial lung disease: A retrospective analysis

Misbah Baqir, Eunhee E. Yi, Thomas V. Colby, Christian W. Cox, Jay H. Ryu, Ulrich Specks

Research output: Contribution to journalArticle

Abstract

Background: The association between interstitial lung disease (ILD) and myeloperoxidase (MPO)-antineutrophil cytoplasmic antibodies (ANCAs) has been described, but pathologic characteristics are not well characterized. Objectives: We assessed the radiologic and pathologic characteristics of ILD in MPO-ANCA–positive patients and the association between ILD and vasculitis, particularly microscopic polyangiitis (MPA). Methods: We retrospectively searched electronic health records to identify MPO-ANCA–positive patients with ILD who underwent surgical lung biopsy at our institution from January 1997 through August 2017. Demographic, clinical, imaging, and pathologic characteristics were analyzed. Results: We identified 18 MPO-ANCA–positive patients with ILD. The median (range) age was 58 (43-75) years, and the cohort included 10 men (56%), 10 former smokers (56%), and 11 patients (61%) had clinical evidence of systemic vasculitis (MPA) at the time of diagnosis of ILD. On high-resolution computed tomography, the most common radiologic pattern was “inconsistent with usual interstitial pneumonia” (UIP) (n=14 [78%]); the other 4 patients (22%) fulfilled the radiologic criteria for the UIP pattern. Honeycombing was seen in 15 patients (83%). Ten patients (56%) had the UIP pattern on biopsy: 4 of these patients had additional inflammatory changes that were not typical of UIP (as seen in patients with idiopathic pulmonary fibrosis), and the other 6 patients had other inflammatory patterns or findings. The presence or absence of MPA did not correlate with pathologic findings. Conclusions: MPO-ANCA–positive patients with ILD do not show the typical UIP pattern as seen in patients with idiopathic pulmonary fibrosis on surgical lung biopsy.

Original languageEnglish (US)
Pages (from-to)195-201
Number of pages7
JournalSarcoidosis Vasculitis and Diffuse Lung Diseases
Volume36
Issue number3
StatePublished - Sep 19 2019

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Interstitial Lung Diseases
Peroxidase
Idiopathic Pulmonary Fibrosis
Microscopic Polyangiitis
Biopsy
Systemic Vasculitis
Lung
Antineutrophil Cytoplasmic Antibodies
Electronic Health Records
Vasculitis
Tomography
Demography

Keywords

  • ILD
  • Interstitial lung disease
  • Microscopic polyangiitis
  • Myeloperoxidase antibodies
  • UIP
  • Usual interstitial pneumonia

ASJC Scopus subject areas

  • Internal Medicine
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Radiologic and pathologic characteristics of myeloperoxidase-antineutrophil cytoplasmic antibody–associated interstitial lung disease : A retrospective analysis. / Baqir, Misbah; Yi, Eunhee E.; Colby, Thomas V.; Cox, Christian W.; Ryu, Jay H.; Specks, Ulrich.

In: Sarcoidosis Vasculitis and Diffuse Lung Diseases, Vol. 36, No. 3, 19.09.2019, p. 195-201.

Research output: Contribution to journalArticle

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title = "Radiologic and pathologic characteristics of myeloperoxidase-antineutrophil cytoplasmic antibody–associated interstitial lung disease: A retrospective analysis",
abstract = "Background: The association between interstitial lung disease (ILD) and myeloperoxidase (MPO)-antineutrophil cytoplasmic antibodies (ANCAs) has been described, but pathologic characteristics are not well characterized. Objectives: We assessed the radiologic and pathologic characteristics of ILD in MPO-ANCA–positive patients and the association between ILD and vasculitis, particularly microscopic polyangiitis (MPA). Methods: We retrospectively searched electronic health records to identify MPO-ANCA–positive patients with ILD who underwent surgical lung biopsy at our institution from January 1997 through August 2017. Demographic, clinical, imaging, and pathologic characteristics were analyzed. Results: We identified 18 MPO-ANCA–positive patients with ILD. The median (range) age was 58 (43-75) years, and the cohort included 10 men (56{\%}), 10 former smokers (56{\%}), and 11 patients (61{\%}) had clinical evidence of systemic vasculitis (MPA) at the time of diagnosis of ILD. On high-resolution computed tomography, the most common radiologic pattern was “inconsistent with usual interstitial pneumonia” (UIP) (n=14 [78{\%}]); the other 4 patients (22{\%}) fulfilled the radiologic criteria for the UIP pattern. Honeycombing was seen in 15 patients (83{\%}). Ten patients (56{\%}) had the UIP pattern on biopsy: 4 of these patients had additional inflammatory changes that were not typical of UIP (as seen in patients with idiopathic pulmonary fibrosis), and the other 6 patients had other inflammatory patterns or findings. The presence or absence of MPA did not correlate with pathologic findings. Conclusions: MPO-ANCA–positive patients with ILD do not show the typical UIP pattern as seen in patients with idiopathic pulmonary fibrosis on surgical lung biopsy.",
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T1 - Radiologic and pathologic characteristics of myeloperoxidase-antineutrophil cytoplasmic antibody–associated interstitial lung disease

T2 - A retrospective analysis

AU - Baqir, Misbah

AU - Yi, Eunhee E.

AU - Colby, Thomas V.

AU - Cox, Christian W.

AU - Ryu, Jay H.

AU - Specks, Ulrich

PY - 2019/9/19

Y1 - 2019/9/19

N2 - Background: The association between interstitial lung disease (ILD) and myeloperoxidase (MPO)-antineutrophil cytoplasmic antibodies (ANCAs) has been described, but pathologic characteristics are not well characterized. Objectives: We assessed the radiologic and pathologic characteristics of ILD in MPO-ANCA–positive patients and the association between ILD and vasculitis, particularly microscopic polyangiitis (MPA). Methods: We retrospectively searched electronic health records to identify MPO-ANCA–positive patients with ILD who underwent surgical lung biopsy at our institution from January 1997 through August 2017. Demographic, clinical, imaging, and pathologic characteristics were analyzed. Results: We identified 18 MPO-ANCA–positive patients with ILD. The median (range) age was 58 (43-75) years, and the cohort included 10 men (56%), 10 former smokers (56%), and 11 patients (61%) had clinical evidence of systemic vasculitis (MPA) at the time of diagnosis of ILD. On high-resolution computed tomography, the most common radiologic pattern was “inconsistent with usual interstitial pneumonia” (UIP) (n=14 [78%]); the other 4 patients (22%) fulfilled the radiologic criteria for the UIP pattern. Honeycombing was seen in 15 patients (83%). Ten patients (56%) had the UIP pattern on biopsy: 4 of these patients had additional inflammatory changes that were not typical of UIP (as seen in patients with idiopathic pulmonary fibrosis), and the other 6 patients had other inflammatory patterns or findings. The presence or absence of MPA did not correlate with pathologic findings. Conclusions: MPO-ANCA–positive patients with ILD do not show the typical UIP pattern as seen in patients with idiopathic pulmonary fibrosis on surgical lung biopsy.

AB - Background: The association between interstitial lung disease (ILD) and myeloperoxidase (MPO)-antineutrophil cytoplasmic antibodies (ANCAs) has been described, but pathologic characteristics are not well characterized. Objectives: We assessed the radiologic and pathologic characteristics of ILD in MPO-ANCA–positive patients and the association between ILD and vasculitis, particularly microscopic polyangiitis (MPA). Methods: We retrospectively searched electronic health records to identify MPO-ANCA–positive patients with ILD who underwent surgical lung biopsy at our institution from January 1997 through August 2017. Demographic, clinical, imaging, and pathologic characteristics were analyzed. Results: We identified 18 MPO-ANCA–positive patients with ILD. The median (range) age was 58 (43-75) years, and the cohort included 10 men (56%), 10 former smokers (56%), and 11 patients (61%) had clinical evidence of systemic vasculitis (MPA) at the time of diagnosis of ILD. On high-resolution computed tomography, the most common radiologic pattern was “inconsistent with usual interstitial pneumonia” (UIP) (n=14 [78%]); the other 4 patients (22%) fulfilled the radiologic criteria for the UIP pattern. Honeycombing was seen in 15 patients (83%). Ten patients (56%) had the UIP pattern on biopsy: 4 of these patients had additional inflammatory changes that were not typical of UIP (as seen in patients with idiopathic pulmonary fibrosis), and the other 6 patients had other inflammatory patterns or findings. The presence or absence of MPA did not correlate with pathologic findings. Conclusions: MPO-ANCA–positive patients with ILD do not show the typical UIP pattern as seen in patients with idiopathic pulmonary fibrosis on surgical lung biopsy.

KW - ILD

KW - Interstitial lung disease

KW - Microscopic polyangiitis

KW - Myeloperoxidase antibodies

KW - UIP

KW - Usual interstitial pneumonia

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