Clinical characteristics and prognosis of nontuberculous mycobacterial lung disease with different radiographic patterns

Chin Chung Shu, Chih Hsin Lee, Chia Lin Hsu, Jann Tay Wang, Jann Yuan Wang, Chong Jen Yu, Li Na Lee

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Rationale: The clinical characteristics and prognostic impact of radiographic patterns of patients with nontuberculous mycobacterial lung disease (NTM-LD) are rarely evaluated. Design: Patients with NTM-LD from 2007 to 2009 in a single medical center in Taiwan were identified. Their radiographic patterns were reviewed and classified into cavitary, bronchiectatic, or consolidative. They were also compared to patients with cavitary pulmonary tuberculosis (TB-LD). Results: Of 481 NTM-LD patients identified, 62, 134, and 56 patients were categorized into cavitary, bronchiectatic, and consolidative groups, respectively. Compared with 180 TB-LD patients, cavitary NTM-LD had male predominance and was associated with higher grades of sputum acid-fast smear (3+ or 4+), prior pulmonary TB, and poor baseline pulmonary function. NTM-LD patients with consolidative pattern were likely to have underlying comorbidity, the highest blood leukocyte count and C-reactive protein, and lowest albumin. In all NTM-LD, the consolidative pattern was independently associated with poor prognosis for 6-month survival. Patients with cavitary Mycobacterium avium complex (MAC)-LD had worse 6-month survival than those with bronchiectatic pattern. Conclusion: In Taiwan, NTM-LD patients with consolidative pattern have the worst prognosis while patients with cavitary pattern have worse survival than those with bronchiectasis in MAC-LD. Because varying radiographic patterns represent different prognoses, understanding the characteristics of NTM-LD patients with different radiographic patterns complements clinical practice.

Original languageEnglish
Pages (from-to)467-474
Number of pages8
JournalLung
Volume189
Issue number6
DOIs
Publication statusPublished - Dec 2011
Externally publishedYes

Fingerprint

Lung Diseases
Mycobacterium avium Complex
Taiwan
Survival
Physicians' Practice Patterns
Lung
Bronchiectasis
Sputum
Leukocyte Count
Pulmonary Tuberculosis
C-Reactive Protein
Comorbidity
Albumins
Acids

Keywords

  • Nontuberculous mycobacteria
  • Radiographic pattern
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Clinical characteristics and prognosis of nontuberculous mycobacterial lung disease with different radiographic patterns. / Shu, Chin Chung; Lee, Chih Hsin; Hsu, Chia Lin; Wang, Jann Tay; Wang, Jann Yuan; Yu, Chong Jen; Lee, Li Na.

In: Lung, Vol. 189, No. 6, 12.2011, p. 467-474.

Research output: Contribution to journalArticle

Shu, Chin Chung ; Lee, Chih Hsin ; Hsu, Chia Lin ; Wang, Jann Tay ; Wang, Jann Yuan ; Yu, Chong Jen ; Lee, Li Na. / Clinical characteristics and prognosis of nontuberculous mycobacterial lung disease with different radiographic patterns. In: Lung. 2011 ; Vol. 189, No. 6. pp. 467-474.
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abstract = "Rationale: The clinical characteristics and prognostic impact of radiographic patterns of patients with nontuberculous mycobacterial lung disease (NTM-LD) are rarely evaluated. Design: Patients with NTM-LD from 2007 to 2009 in a single medical center in Taiwan were identified. Their radiographic patterns were reviewed and classified into cavitary, bronchiectatic, or consolidative. They were also compared to patients with cavitary pulmonary tuberculosis (TB-LD). Results: Of 481 NTM-LD patients identified, 62, 134, and 56 patients were categorized into cavitary, bronchiectatic, and consolidative groups, respectively. Compared with 180 TB-LD patients, cavitary NTM-LD had male predominance and was associated with higher grades of sputum acid-fast smear (3+ or 4+), prior pulmonary TB, and poor baseline pulmonary function. NTM-LD patients with consolidative pattern were likely to have underlying comorbidity, the highest blood leukocyte count and C-reactive protein, and lowest albumin. In all NTM-LD, the consolidative pattern was independently associated with poor prognosis for 6-month survival. Patients with cavitary Mycobacterium avium complex (MAC)-LD had worse 6-month survival than those with bronchiectatic pattern. Conclusion: In Taiwan, NTM-LD patients with consolidative pattern have the worst prognosis while patients with cavitary pattern have worse survival than those with bronchiectasis in MAC-LD. Because varying radiographic patterns represent different prognoses, understanding the characteristics of NTM-LD patients with different radiographic patterns complements clinical practice.",
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