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Clinical Characteristics and Prognosis of Nontuberculous Mycobacterial Lung Disease with Different Radiographic Patterns

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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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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).

Disclosure

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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Authors and Affiliations

  1. Department of Traumatology, Taiwan University Hospital, Taipei, Taiwan

    Chin-Chung Shu

  2. Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan

    Chin-Chung Shu, Chia-Lin Hsu, Jann-Tay Wang, Jann-Yuan Wang & Chong-Jen Yu

  3. Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, No. 289, Jianguo Road, Xindian District, New Taipei City, 231, Taiwan

    Chih-Hsin Lee

  4. Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Li-Na Lee

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  1. Chin-Chung Shu
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  2. Chih-Hsin Lee
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  4. Jann-Tay Wang
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  5. Jann-Yuan Wang
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The TAMI Group

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Correspondence to Jann-Yuan Wang.

Additional information

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

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