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Interstitial Lung Disease, Idiopathic Pulmonary Fibrosis, Pneumonia
The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diagnosed patients.
The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the centers in accordance with routine diagnostic procedures were recorded observationally.
In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms.
Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approacheswere the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total median cost from the patient’s admission to diagnosis was 540 Turkish Lira.
We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution.
2. Katerina M. Antoniou, George A. Margaritopoulos, Sara Tomassetti, FrancescoBonella, UlrichCostabel, VenerinoPoletti. Interstitial lung disease. Eur Respir Rev 2014; 23: 40-54
3. Dove EP, Olson AL, Glassberg MK. Trends in idiopathic pulmonary fibrosis-related mortality in the United States: 2000-2017. Am J Respir Crit Care Med 2019;200:929-931
4. Fernandez Perez ER, Sprunger DB, Ratanawatkul P, Maier LA, Huie TJ, Swigris JJ, et al. Increasing hypersensitivity pneumonitis-related mortality in the United States from 1988 to 2016. Am J Respir Crit Care Med 2019;199:1284-1287
5. William D. Travis, Ulrich Costabel, David M. Hansell at al; on behalf of the ATS/ERS Committee on Idiopathic Interstitial Pneumonias. An Ofﬁcial American Thoracic Society/European Respiratory Society Statement: Update of the International Multidisciplinary Classiﬁcation of the Idiopathic Interstitial Pneumonias. Am J Respir Crit Care Med. 2013: 188;733-748
6. Jette Kornum, Steffen Christensen, Miriam Grijota, Lars Pedersen, PiaWogelius, Annette Beiderbeck, Henrik Toftsorensen. TheIncidence of İnterstitial Lung Disease 1995-2005: a Danish Nationwid Population-Based Study. BMC Pulmonary Medicine. 2008:8;24
7. Benan Musellim, Gulfer Okumus, Esra Uzaslan, Metin Akgün, Erdogan Cetinkaya, Onur Turan, Atila Akkoclu, Armagan Hazar, Nurdan Kokturk, Haluk Celalettin Calisirand Turkish Interstitial Lung Diseases Group. Epidemiology and distribution of interstitial lung diseases in Turkey. ClinRespir J 2014; 8: 55-62
8. A. Karakatsani, D. Papakosta, A. Rapti, K.M. Antoniou, M. Dimadi, A. Markopoulou, P. Latsi, V. Polychronopoulos, G. Birba, Labrakis Ch, D. Bouros. Epidemiology of interstitial lung diseases in Greece. Respiratory Medicine. 2009;103:1122-1129
9. Ganesh Raghu, Martine Remy-Jardin, Jeffrey L. Myers at al. Diagnosis of Idiopathic Pulmonary Fibrosis An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2018;198 (5):44-68
10. Noble PW, Albera C, Bradford WZ, et al.; CAPACITY Study Group. Pirfenidone in patients with idiopathic pulmonary fibrosis (CAPACITY): two randomised trials. Lancet. 2011;377:1760-1769.
11. Richeldi L, du Bois RM, Raghu G, et al. Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med. 2014;370:2071-2082
12. Roy Pleasants, Robert M. Tighe. Management of Idıopathic Pulmonary Fibrosis. Ann Pharmacother. 2019;53(12):1238-1248
13. Robert P. Baughman, Alvin S. Teirstein, Marc A. Judson, Milton D. Rossman, Henry Yeager Jr., Eddy A. Bresnitz, Louis Depalo, Gary Hunninghake, Michael C. Iannuzzi, Carol J. Johns, Geoffrey Mclennan. Clinical Characteristics of Patients in a Case Control Study of Sarcoidosis. Am J Respir Crit Care Med. 2001;15:1885-1889
14. Raghu G, Weycker D, Edelsberg J, et al. Incidence and prevalence of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2006;174 (7):810-816
15. Yang Hu, Liu-Sheng Wang, Ya-Ru Wei, Shan-Shan Du, Yu-Kui Du, Xian He, Nan Li, Ying Zhou, Qiu-Hong Li, Yi-Liang Su, Fen Zhang, Li Shen, Dong Weng, Kevin K. Brown, Hui-Ping Li. Clinical Characteristics of Connective Tissue Disease-Associated Interstitial Lung Disease in 1,044 Chinese Patients. Chest 2016; 149(1):201-208
16. Evans R. Fernandez Perez, Amanda M. Kong, Karina Raimundo, Tilman L. Koelsch, Rucha Kulkarni, Ashley L. Cole. Epidemiology of Hypersensitivity Pneumonitis among an Insured Population in the United States: A Claims-based Cohort Analysis. Ann Am Thorac Soc. 2018;15(4):460-469
17. Moises Selman, Annie Pardo,Talmadge E. King, Jr. Hypersensitivity Pneumonitis Insights in Diagnosis and Pathobiology. Am J Respir Crit Care Med. 2012;186(4): 314-324
18. Larissa Schwarzkop, Sabine Witt, Julia Waelscher, Marcus Polke, Michael Kreuter. Associations between comorbidities, their treatment and survival in patients with interstitial lung diseases – a claims data analysis. Respiratory Research. 2018;19:73
19. Christopher J. Ryerson, Marta Abbritti, Brett Ley, Brett M. Elicker, Kirk D. Jones, Harold R. Collard. Cough Predicts Prognosis İn İdiopathic Pulmonary Fibrosis. Respirology. 2011;16: 969-975
20. Andreas Guenther, Ekaterina Krauss, Silke Tello, Jasmin Wagner, Bettina Paul, Stefan Kuhn, Olga Maurer, Sabine Heinemann, Ulrich Costabel, Maria Asuncion Nieto Barbero, Veronika Müller, Philippe Bonniaud, Carlo Vancheri, Athol Wells, Martina Vasakova, Alberto Pesci, Matteo Sofia, Walter Klepetko, Werner Seeger, Fotios Drakopanagiotakis, Bruno Crestani. The European IPF registry (eurIPFreg): baseline characteristics and survival of patients with idiopathic pulmonary fibrosis. Respiratory Research 2018;19:141
21. Aish Sinha, Kai K. Lee, Gerrard F. Rafferty, Nadia Yousaf, Ian D. Pavord, James Galloway, Surinder S. Birring. Predictors of objective cough frequency in pulmonary sarcoidosis. European Respiratory Journal 2016 47: 1461-1471
22. Jasmine Z. Cheng, Pearce G. Wilcox, Ian Glaspole, Tamera J. Corte, Darra Murphy, Cameron J. Hague, Christopher J. Ryerson. Cough İs Less Common And Less Severe İn Systemic Sclerosis-Associated İnterstitial Lung Disease Compared To Other Fibrotic İnterstitial Lung Diseases. Respirology. 2017;22:1592-7
23. Theodore AC, Tseng CH, Li N, Elashoff RM, Tashkin DP. Correlation of cough with disease activity and treatment with cyclophosphamide in scleroderma interstitial lung disease: findings from the scleroderma lung study. Chest. 2012;142:614-21
24. Gregory P. Cosgrove, Pauline Bianchi, Sherry Danese, David J. Lederer. Barriers to timely diagnosis of interstitial lung disease in the real world: the INTENSITY survey. BMC Pulmonary Medicine. 2018;18:9
25. Ryo Okuda, Eri Hagiwara, Tomohisa Baba, Hideya Kitamura, Terufumi Kato, Takashi Ogura. Safety and efficacy of pirfenidone in idiopathic pulmonary fibrosis in clinical practice. Respiratory Medicine. 2013;107:1431-1437
26. Luca Richeldi, Roland M. du Bois, Ganesh Raghu, Arata Azuma, Kevin K. Brown, Ulrich Costabel, Vincent Cottin, Kevin R. Flaherty, David M. Hansell, Yoshikazu Inoue, Dong Soon Kim, Martin Kolb, Andrew G. Nicholson, Paul W. Noble, Moisés Selman, Hiroyuki Taniguchi, Michele Brun, Florence Le Maulf, Mannaïg Girard, Susanne Stowasser, Rozsa Schlenker-Herceg, Bernd Disse, Harold R. Collard. Efficacy and Safety of Nintedanib in Idiopathic Pulmonary Fibrosis. N Engl J Med 2014;370:2071-82