J Korean Med Sci.  2013 May;28(5):731-737. 10.3346/jkms.2013.28.5.731.

Clinical Significance of Serum Autoantibodies in Idiopathic Interstitial Pneumonia

Affiliations
  • 1Department of Pulmonary and Critical Care Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. dskim@amc.seoul.kr
  • 2Department of Rheumatology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
  • 3Department of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
  • 4Department of Pathology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
  • 5Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, AZ, USA.

Abstract

Although autoantibodies are routinely screened in patients with idiopathic interstitial pneumonia, there are no reliable data on their clinical usefulness. The aim of this study was to investigate the prognostic value of autoantibodies for predicting the development of new connective tissue disease in these patients and also mortality. We conducted retrospective analysis of the baseline, and follow-up data for 688 patients with idiopathic interstitial pneumonia (526 with idiopathic pulmonary fibrosis, 85 with nonspecific interstitial pneumonia, and 77 with cryptogenic organizing pneumonia) at one single tertiary referral center. The median follow-up period was 33.6 months. Antinuclear antibody was positive in 34.5% of all subjects, rheumatoid factor in 13.2%, and other specific autoantibodies were positive between 0.7%-6.8% of the cases. No significant difference in patient survival was found between the autoantibody-positive and -negative groups. However, the presence of autoantibodies, especially antinuclear antibody with a titer higher than 1:320, was a significant predictor for the future development of new connective tissue diseases (relative risk, 6.4), although the incidence was low (3.8% of all subjects during follow-up). In conclusion, autoantibodies are significant predictors for new connective tissue disease development, although they have no prognostic value.

Keyword

Idiopathic Interstitial Pneumonias; Idiopathic Pulmonary Fibrosis; Nonspecific Interstitial Pneumonia; Cryptogenic Organizing Pneumonia; Antinuclear Antibody; Rheumatoid Factor; Autoantibody; Connective Tissue Disease; Incidence; Predictive Factor

MeSH Terms

Aged
Antibodies, Antinuclear/blood
Autoantibodies/*blood
Cohort Studies
Connective Tissue Diseases/pathology
Female
Follow-Up Studies
Humans
Idiopathic Interstitial Pneumonias/*blood/diagnosis
Male
Middle Aged
Prognosis
Retrospective Studies
Rheumatoid Factor/blood
Risk Factors
Tertiary Care Centers
Tomography, X-Ray Computed
Antibodies, Antinuclear
Autoantibodies
Rheumatoid Factor

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