title: Mycobacterial pulmonary infections in patients with idiopathic pulmonary fibrosis.
abstract: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk for developing tuberculosis (TB). However, no studies have been reported regarding the development of nontuberculous mycobacterium (NTM) lung disease (NTMLD). We reviewed 795 patients with IPF from five university hospitals who were diagnosed by histological or radio-clinical criteria. In the 795 patients with IPF, pulmonary infections with mycobacterium tuberculosis (MTB) and NTM were found in 35 (4.4%) and 16 patients (2.0%), respectively, which was a higher frequency than that found in the general population. TB was more common in patients treated with immunosuppressants than in those who did not receive immunosuppressants (2.6% vs 1.4%, P = 0.12). Among the IPF patients who had mycobacterial infections,immunosuppressant users developed TB or NTMLD within 1 yr after treatment with immunosuppressants,while those occurred later than 2 yr after diagnosis of IPF in the subjects that did not receive immunosuppressants. Among 51 IPF patients who had mycobacterial infections, 9 (18%) died during follow-up. Of these, three died due to progression of pulmonary tuberculosis. TB and NTMLD is relatively common in patients with IPF in Korea and may be fatal in some groups. Careful evaluation of TB and NTMLD is necessary not only for immunosuppressant users, but also for nonusers with IPF.
authors.affiliation: Division of Allergy and Respiratory Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Song
authors.forename: Tae Sun
authors.initials: TS
authors.lastname: Shim
authors.forename: Moo-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Hong-Lyeol
authors.initials: HL
authors.lastname: Lee
authors.forename: Soo-Taek
authors.initials: ST
authors.lastname: Uh
authors.forename: Choon-Sik
authors.initials: CS
authors.lastname: Park
authors.forename: Dong Soon
authors.initials: DS
authors.lastname: Kim
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents