Interstitial Lung Disease in India. Results of a Prospective Registry.
Interstitial lung disease (ILD) is a heterogeneous group of acute and chronic inflammatory and fibrotic lung diseases. Existing ILD registries have had variable findings. Little is known about the clinical profile of ILDs in India.



To characterize new-onset ILDs in India by creating a prospective ILD using multidisciplinary discussion (MDD) to validate diagnoses.



Adult patients of Indian origin living in India with new-onset ILD (27 centers, 19 Indian cities, March 2012-June 2015) without malignancy or infection were included. All had connective tissue disease (CTD) serologies, spirometry, and high-resolution computed tomography chest. ILD pattern was defined by high-resolution computed tomography images. Three groups independently made diagnoses after review of clinical data including that from prompted case report forms: local site investigators, ILD experts at the National Data Coordinating Center (NDCC; Jaipur, India) with MDD, and experienced ILD experts at the Center for ILD (CILD; Seattle, WA) with MDD. Cohen's κ was used to assess reliability of interobserver agreement.



A total of 1,084 patients were recruited. Final diagnosis: hypersensitivity pneumonitis in 47.3% (n = 513; exposure, 48.1% air coolers), CTD-ILD in 13.9%, and idiopathic pulmonary fibrosis in 13.7%. Cohen's κ: 0.351 site investigator/CILD, 0.519 site investigator/NDCC, and 0.618 NDCC/CILD.



Hypersensitivity pneumonitis was the most common new-onset ILD in India, followed by CTD-ILD and idiopathic pulmonary fibrosis; diagnoses varied between site investigators and CILD experts, emphasizing the value of MDD in ILD diagnosis. Prompted case report forms including environmental exposures in prospective registries will likely provide further insight into the etiology and management of ILD worldwide.
1 Department of Chest and Tuberculosis.
Sheetu
S
Singh
2 Department of Medicine.
Bridget F
BF
Collins
3 Department of Medicine.
Bharat B
BB
Sharma
4 Department of Pulmonary Medicine, Topiwala National Medical College & BYL Nair Hospital, Mumbai, India.
Jyotsna M
JM
Joshi
5 Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, India.
Deepak
D
Talwar
6 Department of Respiratory Medicine, Chest Care Centre, Kanpur, India.
Sandeep
S
Katiyar
7 Department of Pulmonary Medicine and.
Nishtha
N
Singh
2 Department of Medicine.
Lawrence
L
Ho
8 Department of Chest Disease, Banaras Hindu University, Varanasi, India.
Jai Kumar
JK
Samaria
9 Department of Respiratory Medicine, Institute of Pulmocare and Research, Kolkata, India.
Parthasarathi
P
Bhattacharya
10 Department of Respiratory Medicine, JLN Medical College & Hospital, Ajmer, India.
Rakesh
R
Gupta
11 Department of Chest and Tuberculosis, GSVM Medical College, Kanpur, India.
Sudhir
S
Chaudhari
12 Research Division, Asthma Bhawan, Jaipur, India.
Tejraj
T
Singh
13 Department of Radiology, and.
Vijay
V
Moond
14 Department of Radiology, and.
Sudhakar
S
Pipavath
14 Department of Radiology, and.
Jitesh
J
Ahuja
15 Department of Pulmonary Medicine, Government Medical College, Kozhikode, India.
Ravindran
R
Chetambath
16 National Allergy Asthma Bronchitis Institute, Kolkata, India.
Aloke G
AG
Ghoshal
17 Department of Respiratory Medicine, SoniManipal Hospital, Jaipur, India.
Nirmal K
NK
Jain
18 Department of Chest Medicine, MS Ramaiah Medical College, Bangalore, India.
H J Gayathri
HJ
Devi
19 Department of Pulmonary Medicine, King George's Medical University, Lucknow, India.
Surya
S
Kant
20 Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
Parvaiz
P
Koul
21 Department of Pulmonology & Critical Care, Fortis Hospital, Kolkata, India.
Raja
R
Dhar
22 Department of Pulmonology and Respiratory Medicine, Getwell Hospital and Research Institute, Nagpur, India.
Rajesh
R
Swarnakar
23 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
Surendra K
SK
Sharma
24 Department of Respiratory Medicine, Pulmonary and Sleep Clinic, Kolkata, India.
Dhrubajyoti J
DJ
Roy
25 Department of Pulmonary Medicine, Gauhati Medical College, Guwahati, India.
Kripesh R
KR
Sarmah
26 Department of Radiology, Jankharia Imaging, Mumbai, India; and.
Bhavin
B
Jankharia
27 Department of Pathology, Center for Interstitial Lung Diseases, University of Washington, Seattle, Washington.
Rodney
R
Schmidt
6 Department of Respiratory Medicine, Chest Care Centre, Kanpur, India.
Santosh K
SK
Katiyar
28 Department of Pathology, SMS Medical College, Jaipur, India.
Arpita
A
Jindal
29 Department of Research, IIHMR University, Jaipur, India.
Daya K
DK
Mangal
7 Department of Pulmonary Medicine and.
Virendra
V
Singh
2 Department of Medicine.
Ganesh
G
Raghu
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007194:India; D017563:Lung Diseases, Interstitial / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*; D015203:Reproducibility of Results
India; interstitial lung disease; registry