Abstract
ETIOLOGICAL PROFILE OF CHRONIC DIFFUSE INFILTRATING PNEUMOPATHIES

M. Rjimati§, Z. Biaz, M. Serraj, M. Elbiaze, M. C. Benjelloun and B. Amara

ABSTRACT

Introduction: Chronic diffuse infiltrating pneumonias (DIP) form a heterogeneous group of pathologies, the classification of which is regularly modified; the latest from 2015 highlights 5 major families of chronic DIP. The etiological diagnosis of chronic diffuse infiltrating pneumonia is based on a range of elements discussed, necessarily, during a multidisciplinary discussion meeting (MDD) for etiological diagnostic decision. The aim of this work is to describe the etiological profile of the various chronic DIP followed at the Hassan II hospital in Fez. Methods: This is a retrospective analytical descriptive study conducted at the various follow-up consultations of patients with chronic DIP in the pneumology department of the Hassan II University Hospital Center in Fez. It was spread over a period of 03 years. Results: Of the 315 patients solicited, the age is between 21 and 89 years old, with an average age of 58.49 years. The female gender has a significant predominance with a percentage of 71.11%. Of the 315 chronic DIP files received at consultations, 76.5% were discussed in a multidisciplinary meeting with an average delay of 4.6 months. Of all the files discussed in DMD (N = 241), 71% concluded with an etiological diagnosis, 22.8% the diagnosis was not confirmed, the rest is being explored. We analyzed the 315 records of chronic DIP patients. The etiologies were retained on the results of the thoracic scans, the results of the BAL, the bronchial biopsies and the results of the immunological assessments. The results according to the ATS/ERS 2015 classification showed that the sarcoidosis-type granulomatosis etiology is the leading etiology, neck and neck with DIP of known cause with respective percentages of 32% and 36%, followed by the idiopathic DIP with 25%, then the particular DIP with 7% and finally the IPAF entity with a single case. The leader of the DIP of known causes, are the connectivities with more than 50%. The leader of idiopathic diffuse infiltrating pneumopathies is idiopathic pulmonary fibrosis with 49.3%. The eosinophilia lung (50%) represents half of particular DIP. Conclusion: DIP constitute a very heterogeneous group, whose etiological diagnosis remains complex and necessary for a good therapeutic attitude. Faced with the diversity and heterogeneity of etiologies evoked in chronic DIP, the diagnostic and therapeutic strategy requires a judicious elaboration between clinicians, radiologists and pathologists after which a multidisciplinary decision is taken (MDD).

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