Abstract
BackgroundIdiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis share commonalities in pathogenesis shifting haemostasis balance towards the procoagulant and antifibrinolytic activity. Several studies have suggested an increased risk of venous thromboembolism in IPF. The association between venous thromboembolism and chronic hypersensitivity pneumonitis has not been studied yet.MethodsA retrospective cohort study of IPF and chronic hypersensitivity pneumonitis patients diagnosed in single tertiary referral center between 2005 and 2018 was conducted. The incidence of symptomatic venous thromboembolism was evaluated. Risk factors for venous thromboembolism and survival among those with and without venous thromboembolism were assessed.ResultsA total of 411 (259 IPF and 152 chronic hypersensitivity) patients were included (mean age 66.7 ± 8.4 vs 51.0 ± 13.3 years, respectively). There were 12 (4.6%) incident cases of venous thromboembolism in IPF and 5 (3.3%) in chronic hypersensitivity pneumonitis cohort. The relative risk (RR) of venous thromboembolism in chronic hypersensitivity pneumonitis was not significantly different to that found in patients with IPF (7.1 vs 11.8/1000 person-years, RR 1.661 95% CI 0.545–6.019, respectively).The treatment with systemic steroids (OR 5.38; 95% CI 1.65–18.8, p = 0.006) and GAP stage 3 (OR 7.85; 95% CI 1.49–34.9; p = 0.037) were significant risk factors for venous thromboembolism in IPF. Arterial hypertension and pulmonary hypertension significantly increased risk of venous thromboembolism in chronic hypersensitivity pneumonitis. There were no significant differences in survival between patients with and without venous thromboembolism.ConclusionsThe patients with chronic hypersensitivity pneumonitis have a marked increase in the risk of venous thromboembolism, similar to the patients with IPF. Venous thromboembolism does not affect the survival of patients with IPF and chronic hypersensitivity pneumonitis.
Highlights
Idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis share commonalities in pathogenesis shifting haemostasis balance towards the procoagulant and antifibrinolytic activity
The patients with chronic hypersensitivity pneumonitis have a marked increase in the risk of venous thromboembolism, similar to the patients with IPF
Venous thromboembolism does not affect the survival of patients with IPF and chronic hypersensitivity pneumonitis
Summary
Idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis share commonalities in pathogenesis shifting haemostasis balance towards the procoagulant and antifibrinolytic activity. The association between venous thromboembolism and chronic hypersensitivity pneumonitis has not been studied yet. Chronic hypersensitivity pneumonitis (cHP), is a complex diffuse parenchymal disease caused by repeated and prolonged exposure to inhaled antigens in susceptible individuals, leading to an inflammatory response in the lungs, and, in some patients, to development of pulmonary. The experimental study on bronchoalveolar lavage fluid (BALF) of patients with hypersensitivity pneumonitis has demonstrated that the alveolar haemostatic balance is shifted in favour of procoagulant and antifibrinolytic activity [2], to patients with idiopathic pulmonary fibrosis (IPF), the most common progressive fibrotic disorder of unknown aetiology and unfavourable prognosis [3, 4]. Several population-based studies of the last decade showed an association between IPF and venous thromboembolism (VTE), indicating an increased risk of prothrombotic state, increased incidence and prevalence of VTE in IPF patients, and increased mortality [9,10,11,12,13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
