Juan Ignacio Enghelmayer

University of Buenos Aires

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Gabriela Tabaj

Instituto Nacional del Tórax

Tulio Papucci

Centro Científico Tecnológico - Bahía Blanca

Sílvia Quadrelli

University of Buenos Aires

Brenda Varela

Hospital Alemán

Silvana Acuña

Hospital de Clínicas "José de San Martín"

María Otaola

Instituto Nacional de Rehabilitación Psicofísica

Cora Gabriela Legarreta

University of Buenos Aires

Javier Sebastiani

Hospital Privado de Comunidad

Federico Campins

Hospital Privado de Comunidad

Diana Lancellotti

Hospital Privado de Comunidad

Cooperative Institutions

Royal Prince Alfred Hospital

Hospital de Clínicas "José de San Martín"

University of Buenos Aires

Isabela State University

University of Colorado Denver

Royal Brompton Hospital

Imperial College London

Lung Institute

National Jewish Health

University of Colorado Anschutz Medical Campus

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A Patient With Autoimmune Hepatitis and Interstitial Lung Disease

CHEST Journal (2013)

Juan Ignacio Enghelmayer Tulio Papucci Julio Silio Luciano Melatini

Autoimmune Hepatitis

10.1378/chest.1701233

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False-Positive PET Scan in a Patient With Lipoid Pneumonia Simulating Malignancy

CHEST Journal (2013)

Juan Ignacio Enghelmayer Tulio Papucci Luciano Melatini Julio Silio

10.1378/chest.1699499

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Asymptomatic autoimmune interstitial lung disease: Neither subclinical nor clinically insignificant

Juan Ignacio Enghelmayer Adrián Gaser Carolina Meza Guillermo Besteiro Viviana Moyano

Subclinical infection

10.1183/13993003.congress-2024.pa4275

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[Hypersensitivity pneumonitis. A series of nine cases with surgical lung biopsy].

PubMed (2017)

Ricardo Adrián Gómez Tejada Cora Gabriela Legarreta Juan Ignacio Enghelmayer Milagros Dianti Silvana Acuña

In a series of nine patients with histopathological diagnosis of hypersensitivity pneumonitis, we retrospectively evaluated clinical data, exposure related factors, pulmonary function tests and chest computed tomography scans. A restrictive abnormality with reduction of diffusion capacity for carbon monoxide was mainly found. Chest scans showed fibrotic patterns in most cases; ground glass attenuation areas with mosaic pattern and consolidation in the rest. Exposure to avian antigens, cereal grains and air conditioners contaminated with fungi yeasts and bacteria, were suspected from clinical data in two-thirds of the cases. Since there are no unique features that allow differentiation from other interstitial lung diseases, a high clinical suspicion is required and a careful search of environmental exposure to possible antigens is needed that, together with clinical, radiological and pathological data, may lead to diagnosis.

Hypersensitivity pneumonitis

Lung biopsy

Abnormality

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[Palliative care in interstitial lung disease: A national analysis of access and knowledge of Argentine pulmonologists].

PubMed (2024)

Horacio Matías Castro Martín Eduardo Fernández María Paz Cáceres Beatriz Gil Juan Ignacio Enghelmayer

Palliative care (PC) is essential in the treatment of patients with interstitial lung diseases (ILD). There is no data on the management of PC by pulmonologists in Argentina for ILD patients. This study aimed to describe the approach to PC in ILD patients in Argentina.

Pulmonologists

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Anti-Ro-52 antibodies in interstitial lung disease associated with autoimmune disorders

Juan Ignacio Enghelmayer A. Moruno Rodríguez Tamara Arias María José López Meiller Marina Garcia Carrasco

Background: Interstitial lung disease (ILD) is a frequent manifestation of connective tissue diseases (CTD). Some studies show a high prevalence of Anti-Ro52 in patients with ILD associated CTD and potentially related with poor prognosis. Objectives: To describe demographic, clinical, serological and radiological features, treatment and outcomes in a patient cohort. Methods: We conducted a longitudinal descriptive study incluiding patients from 2 centers in Argentina who exhibit ILD and Ro52. Results: 24 patients were included (95.8% female) with a mean age of 58 years. The average follow-up was 29.5 months. Most patients had chronic pulmonary symptoms.16 patients (66.6%) met the criteria for CTD, while 20.9% were unclassifiable and 12.5% were diagnosed with interstitial pneumonia with autoimmune features. Within the CTD group, half of the patients had idiopathic inflammatory myopathies while systemic sclerosis and overlap syndrome were equally present (18.75%). Most patients (95.8%) had positive antinuclear antibodies, and 62.5% had a positive total Anti Ro. Seven patients (29%) had an isolated Ro52-positive (negative for total Anti Ro); 29.1% had positive Rheumatoid factor and 15% had Anti la positive. Basal FVC showed mild restriction and DLCO was moderately reduced. Both values did not significantly change over time. Most patients had NSIP pattern on CT-scan (63.6%), and the most common treatment was corticosteroids (66.6%). One patient died (4.1%), 14 patients had hospital admissions (58.3%), and 2 required oxygen therapy (8.3%). Conclusions: Most patients with ILD-RO52 exhibited association with CTD. Ro52 antibodies did not correlate with the presence of total SSA-Ro antibodies.

Overlap syndrome

CTD

DLCO

Usual interstitial pneumonia

Rheumatoid factor

Scleroderma (fungus)

10.1183/13993003.congress-2023.pa1166

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Predictors of pulmonary-functional decline in systemic sclerosis: A university hospital experience

Eva Ailín Vallejos Federico Felder S. Lopez Leiva Juan Ignacio Enghelmayer Ramiro Gómez

Introduction: Pulmonary disease is the leading cause of morbidity and mortality in systemic sclerosis (SSc) patients; however, prognostication remains challenging. There is lack of consensus about the diagnostic accuracy of functional and anatomic tests Objective: Determinate the diagnostic performance, individually and combined, of anatomic and functional testing for pulmonary functional decline. Methods: We conducted a retrospective observational cohort study. All adults patients with diagnosis of SSc according to ACR/EULAR criteria during 2007 and 2018 were analyzed. Of the total of 201 patients, 95 offered complete record of clinical features, high resolution computed tomography (HRCT) at baseline and Pulmonary function test (PFT). PFT included: FVC, TLC and DLCO. Progression was defined as a ≥ 10% decrease in FVC at 2 year-control. Results: Among the 95 patients: 87 (91,6%) were women, mean age was 57 +/- 12 years. 53 (55,8%) showed interstitial lung disease (ILD) on HRCT and 26 (27,4%) had functional progression. Regarding the PFT of progressors and non-progressors groups: TLC (%of predicted) 86,5 vs 91,5 (p=0,006); DLCO (%of predicted) 70,0 vs 81,0 (p=0,035). In multivariated analysis HRCT was independently related to functional progression (p= 0,040). Negative predicted value for HRCT was 90,24%. In order to combine the diagnosis value of both test (HRCT and PFT) we applied Net reclassification index (NRI): NRI=+0,07 for TLC in all scenarios and NRI=+0,22 in case of pathologic HRCT. Conclusions: Combination of HRCT and a complete PFT at baseline can help predict functional decline. HRCT may be preferred as first line screening tool whereas TLC can outperform the risk event prediction.

DLCO

High-resolution computed tomography

10.1183/13993003.congress-2019.pa4730

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Interstitial Lung Disease Associated with Connective Tissue Disease (CTD-ILD): Retrospective Multicentric Study

Marta García Moyano Florencia Vivero Acosta Daniel Martín Iglesias Juan Ignacio Enghelmayer Diana Lancellotti

Retrospective, observational, multicentric study of a CTD-ILD cohort from 30 centers in Argentina, Uruguay and Spain, describing demographic, functional, radiological characteristics, applied treatments, evaluating progression and response to therapy based on respiratory functionalism (LFT). Evolution was analyzed according to the variation of %FVC according to the baseline at 6-12 months of IT. Progression: %FVC fall >10%. Stability: variation of %CVF <10% (rise or fall). Results: Table 1. Characteristics HRCT, %FVC, %DCO, IT, severe infections and death. Conclusions: -Early immunosuppressive therapy (IT) can modify the evolution of CTD-ILD: there is a statistical association between late IT and LFT deterioration. -%79 of patients showed improvement or stability after treatment. -%26.5 of the patients with CTD-ILD presented progression despite immunosuppression, while inflammatory myopathies and other CTDs showed a better response.

CTD

10.1183/13993003.congress-2020.754

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Comparing Transbronchial Cryobiopsy and Surgical Biopsy in Idiopathic Pulmonary Fibrosis

American Journal of Respiratory and Critical Care Medicine (2019)

Sílvia Quadrelli Juan Ignacio Enghelmayer María Otaola Edgardo Sobrino

presumably with access to clinical information as well as both TBLC and SLB specimens) and the final diagnosis made at the second multidisciplinary assessment (MDA2) occurred in 17 of 21 cases.This is better than the concordance observed between both blinded SLB and MDA2 (13/21 cases) and TBLC and MDA2 (10/21 cases).Although the additional tissue that local pathologists would have had may be responsible for this difference, we wondered if access to clinical information may have been the major driver.Finally, if an MDA meeting is taken as the gold standard for ILD diagnosis, both blinded SLB and TBLC performed poorly, and the difference in concordance between pathology specimens and MDA2 (13/21 cases for SLB vs. 10/21 cases for TBLC) did not appear dramatic.Given the potential morbidity associated with either biopsy approach, many questioned whether lung biopsy of any kind truly leads to meaningful improvements in clinical outcomes in ILD (6, 7).In conclusion, we commend the authors for their well-done study, and acknowledge our ongoing confusion about the utility of lung histology for ILD diagnosis.Despite the poor concordance between TBLC and SLB, we hope cryobiopsy remains an area of study, as this paper has not completely "cooled off" our interest in this new and less invasive diagnostic technique.

10.1164/rccm.201905-1058le

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COVID-19 pneumonia and clinical follow-up: results of a prospective cohort

10.01 - Respiratory infections and bronchiectasis (2021)

Eva Ailín Vallejos Sabrina Resnik Florencia Santtia Laura Barria Federico Felder

Introduction: COVID-19 pandemic has led to a rise in hospitalized patients with viral pneumonia and we are still learning about the follow-up process. Objective: To describe a cohort of hospitalized patients with COVID pneumonia and the clinical follow up once discharged. Methods: Prospective cohort study. COVID pneumonia patients from August 2020 to January 2021 were analyzed (n=72), with a standardized clinical follow-up a month after discharge. We describe clinical features, extent of pneumonia and treatment provided. We define Extent Pneumonia as an affection of ≥ 4 of 6 radiographic zones and/or 3 of 5 lobes in chest CT and compare vs Non extent pneumonia. Lastly, we describe the findings on the clinical follow-up. Results: Table 1: Cohort´s description. Table 2: Extent and Non extent pneumonia comparison. Clinical follow-up: 8(11.1%) patients persist symptomatic after discharge (4cough-3dyspnea-1anosmia). Conclusions: We present a thorough description of clinical data and our findings define the features associated with extent pneumonia. The clinical follow-up showed a relatively low frequency of symptom persistence.

Viral Pneumonia

10.1183/13993003.congress-2021.pa3650

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