Clinical analysis of 25 cases of interstitial pneumonia with autoimmune features

Objective To analyze the clinical features, natural course, risk factors and prognosis of interstitial pneumonia with autoimmune features(IPAF). Methods The Clinical manifestations, serological features, morphological features, lung function and inflammatory markers of 25 patients with IPAF in the Affiliated Hospital of Medical School of Ningbo University from September 2015 to March 2018 were retrospectively investigated. Results There were 9 males and 16 females, aging 41 to 84 years(mean 58.8±13.0), and 6 patients had a history of smoking. The most common initial symptoms were cough(21/25), expectoration(16/25), and shortness of breath(18/25). The most prevalent systemic symptoms were inflammatory arthritis and polyarticular morning joint stiffness(6/25), followed by Raynaud`s phenomenon(5/25). More than half of the serological manifestations were ANA ≥ 1:320(13/25). Nonspecific interstitial pneumonia(NSIP, 10/25) was the most common chest high resolution CT(HRCT) pattern, followed by organic pneumonia(OP, 5/25). Pulmonary function was mainly diffuse dysfunction(15/22) and/or restrictive ventilatory dysfunction(16/22). In the initial diagnosis of IPAF, there was a significant increase in inflammatory markers, erythrocyte sedimentation(ESR, 20/25), hypersensitive C-reactive protein(13/25), and leukocyte count(6/25). Conclusion IPAF are more common in non-smoking women, and NSIP is the most common HRCT pattern. The clinical manifestations are complex and diverse, but lack of specificity, sometimes it is difficult to distinguish from pulmonary infection. The correct diagnosis should be based on extrapulmonary manifestations, serological and imaging features.