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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 3. Idiopathic Nonspecific Interstitial Pneumonia

Tuberculosis and Respiratory Diseases 2019년 82권 4호 p.277 ~ 284
 ( Lee Jong-Min ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine

 ( Kim Yong-Hyun ) - Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Internal Medicine
 ( Kang Ji-Young ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
 ( Jegal Yang-Jin ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
 ( Park So-Young ) - Chungnam National University Hospital Department of Internal Medicine

Abstract


Idiopathic nonspecific interstitial pneumonia (NSIP) is one of the varieties of idiopathic interstitial pneumonias. Diagnosis of idiopathic NSIP can be done via multidisciplinary approach in which the clinical, radiologic, and pathologic findings were discussed together and exclude other causes. Clinical manifestations include subacute or chronic dyspnea and cough that last an average of 6 months, most of which occur in non-smoking, middle-aged women. The common findings in thoracic high-resolution computed tomography in NSIP are bilateral reticular opacities, traction bronchiectasis, reduced volume of the lobes, and ground-glass opacity in the lower lungs. These lesions can involve diffuse bilateral lungs or subpleural area. Unlike usual interstitial pneumonia, honeycombing is sparse or absent. Pathology shows diffuse interstitial inflammation and fibrosis which are temporally homogeneous, namely NSIP pattern. Idiopathic NSIP is usually treated with steroid only or combination with immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, and mycophenolate mofetil. Prognosis of idiopathic NSIP is better than idiopathic pulmonary fibrosis. Many studies have reported a 5-year survival rate of more than 70%.

키워드

Lung Diseases, Interstitial; Idiopathic Interstitial Pneumonias; Guideline
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