Document Detail


Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: a systematic overview.
MedLine Citation:
PMID:  21471097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is being recognized with increasing frequency. Diagnostic and treatment information is limited. A systematic review is presented, focusing on patient demographics, clinical presentation, diagnosis, treatment options, and outcomes. A systematic electronic literature search was conducted for adult DIPNECH cases reported in the English literature during the past 6 years. Twenty-four DIPNECH cases were identified. Another case from our institution is contributed. Women represent 92% (23 of 25). Mean age at diagnosis was 58 years (range, 36-76 yr). Most were nonsmokers (16 of 24). Symptoms included cough (71%), dyspnea (63%), and wheezing (25%) occurring days to years before diagnosis. Pulmonary function testing showed obstructive ventilatory disease in 54%. Lung nodules were seen in 15 patients (63%), ground-glass attenuation in 7 patients (29%), and bronchiectasis in 5 patients (21%). Histological confirmation required surgical lung biopsy for 88%; however, transbronchial biopsies alone were diagnostic in three patients. Treatments strategies included systemic and inhaled corticosteroids, bronchodilators, and lung resection. Available follow-up data in 17 patients showed 6 clinically improved, 7 who remained stable, and 4 clinically deteriorated. The majority of patients presenting with DIPNECH are middle-aged females with symptoms of cough and dyspnea; obstructive abnormalities on pulmonary function testing; and radiographic imaging showing pulmonary nodules, ground-glass attenuation, and bronchiectasis. In general, the clinical course remains stable; however, progression to respiratory failure does occur. Long-term follow-up and treatment remains incomplete. Establishment of a national multicenter DIPNECH registry would allow formulation of optimal evidence-based guidelines for management of these patients.
Authors:
Adrienne A Nassar; Dawn E Jaroszewski; Richard A Helmers; Thomas V Colby; Bhavesh M Patel; Farouk Mookadam
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2011-03-25
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  184     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-08     Completed Date:  2011-09-13     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  8-16     Citation Subset:  AIM; IM    
Affiliation:
Division of Internal Medicine, Department of Medicine, Mayo Clinic, Scottsdale, AZ 85259-5499, USA.
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MeSH Terms
Descriptor/Qualifier:
Cough / etiology
Dyspnea / etiology
Female
Humans
Hyperplasia
Lung / pathology
Lung Neoplasms / diagnosis*,  pathology,  physiopathology
Middle Aged
Multiple Pulmonary Nodules / diagnosis,  pathology
Neuroendocrine Cells / pathology*
Precancerous Conditions / diagnosis*,  pathology,  physiopathology
Respiratory Function Tests
Comments/Corrections
Comment In:
Am J Respir Crit Care Med. 2012 Feb 1;185(3):341; author reply 341-2   [PMID:  22298367 ]

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