PT  - JOURNAL ARTICLE
AU  - Morven E.M. Wilkie
AU  - James D. Chalmers
AU  - Robin P. Smith
AU  - Stuart Schembri
TI  - Clinical significance of autoantibody screening in patients with idiopathic pulmonary fibrosis
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P2339
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P2339.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P2339.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - IntroductionAutoantibody screening is frequently performed in patients with idiopathic pulmonary fibrosis (IPF), but the clinical relevance of positive autoantibodies without clinically objective connective tissue disease is unclear.MethodsA retrospective analysis was made of 114 patients with IPF. Data was collected on all autoimmune tests performed. Patients were followed up for 3 years or until death.ResultsMedian age was 72 years (interquartile range 65-77). 61.4% male. 42 had positive autoantibody testing (36.8%). Antinuclear antibody (ANA) was positive in 28.9%. 11 patients had positive antineutrophil cytoplasmic antibody (ANCA). 6 patients had positive rheumatoid factor and 1 had positive cyclic citrullinated peptide test.Comparing patients with positive tests and those without, positive autoantibodies were more frequently seen in females (64.8% vs 31.1%,p=0.01). Patients with positive autoantibodies were of similar age (median age 73 years IQR 67-77 vs median 69 years 62-78,p=0.3).Using the GAP index, a validated prognostic tool in IPF, the severity of lung disease was greater in the autoantibody positive group-mean score 3.7 SD 1.4 in the positives and 3.1 SD 1.5 in the negatives, p=0.048.Mortality rate was 31% in the autoantibody positive group and 13.9% in the negative group. Adjusting for baseline difference in severity between the groups, positivity was not associated with increased mortality (adjusted odds ratio 1.63 95% CI 0.53-5.03,p=0.4).Conclusion In our cohort, positive autoantibodies are common in IPF and are more common in female patients with more severe disease. However, positive autoantibodies do not appear to be an independent predictor of poor outcome.