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Acute exacerbation of IPF following diagnostic bronchoalveolar lavage procedures.
MedLine Citation:
PMID:  22138357     Owner:  NLM     Status:  Publisher    
BACKGROUNDS: Bronchoalveolar lavage (BAL) is generally regarded as a safe diagnostic procedure. However, acute exacerbation after BAL is increasingly recognized as a specific complication for patients with idiopathic pulmonary fibrosis (IPF). So far little is known about the correlation between BAL and acute exacerbation of IPF (AE-IPF). METHODS: A cohort of 112 IPF patients at a single institution was analyzed retrospectively. We defined BAL-related AE-IPF as development of AE-IPF within 30 days after the procedure. The incidence rate of AE-IPF per person-month during the post-BAL period was compared with that after the post-BAL period. The relative risk was estimated as the former rate divided by the latter. We also reviewed the previous literature. RESULTS: Four AE-IPF cases occurred during the 201 person-month post-BAL period. The risk of AE-IPF was significantly elevated within 30 days after BAL (rate ratio = 4.12; 95% CI = 1.03-12.2). None of the 111 initial BAL procedures were followed by AE-IPF within a month. In a post hoc analysis, the relative risk of developing AE after second or later BAL procedures was estimated to be considerably higher (rate ratio = 9.10; 95% CI = 2.27-26.98). Twelve cases of BAL-induced AE-IPF were found in our study and in the literature review. Among them, nine showed moderate to severe functional impairment, and eight had either findings of leukocytosis, positive C-reactive protein, or neutrophilia in BAL. CONCLUSIONS: These results suggest that IPF patients should be carefully monitored after BAL, especially those with functional impairment or active inflammation.
Koji Sakamoto; Hiroyuki Taniguchi; Yasuhiro Kondoh; Kenji Wakai; Tomoki Kimura; Kensuke Kataoka; Naozumi Hashimoto; Osamu Nishiyama; Yoshinori Hasegawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-2
Journal Detail:
Title:  Respiratory medicine     Volume:  -     ISSN:  1532-3064     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan; Department of Respiratory Medicine and Allergy, Tosei General Hospital, Nishioiwake-cho, Seto-shi, Aichi 489-8642, Japan.
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