Clinical, Radiological and Functional Profile of Patients with Diffuse Parenchymal Lung Disease (DPLD)
Author(s): Muhammad Humayoun Kabir, Abdullah Al Faruk, Nazmul Haque Sarker
Introduction: Diffuse parenchymal lung disease (DPLD) can be caused by connective tissue diseases and exogenous factors such as inhalation of organic or inorganic dust of environmental, domestic, or occupational origin. However, a genetic predisposition has been regularly evoked in the genesis of DPLD, and a large group remains idiopathic. We in the current study tried to evaluate the clinical, radiological, and functional profile of patients with diffuse parenchymal lung disease (DPLD).
Methods: This cross-sectional prospective study was conducted in the Department of Respiratory Medicine, Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh from January to June 2023. A total of n=100 cases were included in the present study based on the inclusion and exclusion criteria. Written consent was obtained from all the participants of the study after explaining the nature of the study in the vernacular language. Spirometry with measurement of the carbon monoxide diffusion capacity (DLCO), six-minute walk distance (6MWD), post-exercise desaturation, and radiological investigations like chest roentgenograms (CXR) and high-resolution computerized tomography (HRCT) thorax were reported.
Results: A total of n=100 cases were included in the present study based on the inclusion and exclusion criteria. The age of distribution of cases was from 25 years to 77 years. The maximum number of cases was from the age group 51 – 60 years. The mean age of the cases in the study group was 54.5 ± 10.25 years. Average duration of symptoms in patients was 42.54 (6.1) months. End-inspiratory Velcro crackles were the most common examination finding in 93 (93.0%) followed by clubbing in 55 (55.0%). Post-exercise desaturation was found in n=89 patients (89.0%). The common diagnosis was idiopathic interstitial pneumonias (IIP) n=58 (58.0%). Other common etiologies were granulomatous diseases like sarcoidosis in n=7 (7.0%) hypersensitivity pneumonitis in n=7 (7.0%) and connective tissue disease associated with DPLD in n=17 (17.0%). Rest n=3 cases included occupational DPLD, drug- induced DPLD, and topical pulmonary eosinophilia.
Conclusion: Diffuse parenchymal lung disease (DPLD) is a chronic respiratory disease, and its diagnosis must be done with a multidisciplinary approach without the requirement of a lung biopsy. Interstitial pulmonary fibrosis has a poorer prognosis compared to Nonspecific interstitial pneumonia despite optimal treatment. Cases with connective tissue disease-associated DPLD, hypersensitivity pneumonitis and sarcoidosis show exceptional response to therapy.