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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Acknowledgments
The authors thank the Institute for Biotechnology and Medicine Industry, Taiwan, for their academic funding and the National Taiwan University Hospital for funding (NTUH.100-N1685) and equipment support (the 8th Core Lab).
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All of the authors declare that there were no financial, professional, or other personal interests of any nature related to a product, service, and/or company that would influence the study results.
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Taiwan Anti-Mycobacteria Investigation (TAMI) group: Jann-Yuan Wang, Li-Na Lee, Chong-Jen Yu, Pan-Chyr Yang, Wei-Juin Su, Chin-Chung Shu, Hsin-Chih Lai, Chih-Hsin Lee, Ming-Chih Yu.
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Shu, CC., Lee, CH., Hsu, CL. et al. Clinical Characteristics and Prognosis of Nontuberculous Mycobacterial Lung Disease with Different Radiographic Patterns. Lung 189, 467–474 (2011). https://doi.org/10.1007/s00408-011-9321-4
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DOI: https://doi.org/10.1007/s00408-011-9321-4