Non-specific interstitial pneumonia in cigarette smokers: a CT study |
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Authors: | Katharina Marten David Milne Katerina M Antoniou Andrew G Nicholson Rachel C Tennant Trevor T Hansel Athol U Wells David M Hansell |
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Institution: | 1. Department of Radiology, Georg August University of G?ttingen, Robert-Koch-Str. 40, 37075, G?ttingen, Germany 2. Department of Radiology, Green Lane Hospital, Auckland, New Zealand 3. Department of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece 4. Department of Histopathology, Royal Brompton Hospital, London, UK 5. Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK 6. Clinical Trials Unit, Royal Brompton Hospital, London, UK 7. Department of Radiology, Royal Brompton Hospital, London, UK
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Abstract: | The goal of this study was to seek indirect evidence that smoking is an aetiological factor in some patients with non-specific
interstitial pneumonia (NSIP). Ten current and eight ex-smokers with NSIP were compared to controls including 137 current
smokers with no known interstitial lung disease and 11 non-smokers with NSIP. Prevalence and extent of emphysema in 18 smokers
with NSIP were compared with subjects meeting GOLD criteria for chronic obstructive pulmonary disease (COPD; group A; n = 34) and healthy smokers (normal FEV1; group B; n = 103), respectively. Emphysema was present in 14/18 (77.8%) smokers with NSIP. Emphysema did not differ in prevalence between
NSIP patients and group A controls (25/34, 73.5%), but was strikingly more prevalent in NSIP patients than in group B controls
(18/103, 17.5%, P < 0.0005). On multiple logistic regression, the likelihood of emphysema increased when NSIP was present (OR = 18.8; 95% CI = 5.3–66.3;
P < 0.0005) and with increasing age (OR = 1.04; 95% CI = 0.99–1.11; P = 0.08). Emphysema is as prevalent in smokers with NSIP as in smokers with COPD, and is strikingly more prevalent in these
two groups than in healthy smoking controls. The association between NSIP and emphysema provides indirect support for a smoking
pathogenesis hypothesis in some NSIP patients. |
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Keywords: | Nonspecific interstitial pneumonia Pulmonary fibrosis Emphysema Cigarette smoking |
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