Interstitial Lung Disease in India. Results of a Prospective Registry.
RATIONALE
Interstitial lung disease (ILD) is a heterogeneous group of acute and chronic inflammatory and fibrotic lung diseases. Existing ILD registries have had variable findings. Little is known about the clinical profile of ILDs in India.


OBJECTIVES
To characterize new-onset ILDs in India by creating a prospective ILD using multidisciplinary discussion (MDD) to validate diagnoses.


METHODS
Adult patients of Indian origin living in India with new-onset ILD (27 centers, 19 Indian cities, March 2012-June 2015) without malignancy or infection were included. All had connective tissue disease (CTD) serologies, spirometry, and high-resolution computed tomography chest. ILD pattern was defined by high-resolution computed tomography images. Three groups independently made diagnoses after review of clinical data including that from prompted case report forms: local site investigators, ILD experts at the National Data Coordinating Center (NDCC; Jaipur, India) with MDD, and experienced ILD experts at the Center for ILD (CILD; Seattle, WA) with MDD. Cohen's κ was used to assess reliability of interobserver agreement.


MEASUREMENTS AND MAIN RESULTS
A total of 1,084 patients were recruited. Final diagnosis: hypersensitivity pneumonitis in 47.3% (n = 513; exposure, 48.1% air coolers), CTD-ILD in 13.9%, and idiopathic pulmonary fibrosis in 13.7%. Cohen's κ: 0.351 site investigator/CILD, 0.519 site investigator/NDCC, and 0.618 NDCC/CILD.


CONCLUSIONS
Hypersensitivity pneumonitis was the most common new-onset ILD in India, followed by CTD-ILD and idiopathic pulmonary fibrosis; diagnoses varied between site investigators and CILD experts, emphasizing the value of MDD in ILD diagnosis. Prompted case report forms including environmental exposures in prospective registries will likely provide further insight into the etiology and management of ILD worldwide.
['Singh|Sheetu|S|', 'Collins|Bridget F|BF|', 'Sharma|Bharat B|BB|', 'Joshi|Jyotsna M|JM|', 'Talwar|Deepak|D|', 'Katiyar|Sandeep|S|', 'Singh|Nishtha|N|', 'Ho|Lawrence|L|', 'Samaria|Jai Kumar|JK|', 'Bhattacharya|Parthasarathi|P|', 'Gupta|Rakesh|R|', 'Chaudhari|Sudhir|S|', 'Singh|Tejraj|T|', 'Moond|Vijay|V|', 'Pipavath|Sudhakar|S|', 'Ahuja|Jitesh|J|', 'Chetambath|Ravindran|R|', 'Ghoshal|Aloke G|AG|', 'Jain|Nirmal K|NK|', 'Devi|H J Gayathri|HJ|', 'Kant|Surya|S|', 'Koul|Parvaiz|P|', 'Dhar|Raja|R|', 'Swarnakar|Rajesh|R|', 'Sharma|Surendra K|SK|', 'Roy|Dhrubajyoti J|DJ|', 'Sarmah|Kripesh R|KR|', 'Jankharia|Bhavin|B|', 'Schmidt|Rodney|R|', 'Katiyar|Santosh K|SK|', 'Jindal|Arpita|A|', 'Mangal|Daya K|DK|', 'Singh|Virendra|V|', 'Raghu|Ganesh|G|']
D003937:Diagnosis, Differential D005260:Female D006801:Humans D007194:India D017563:Lung Diseases, Interstitial D008297:Male D008875:Middle Aged D011446:Prospective Studies D012042:Registries D015203:Reproducibility of Results
interstitial lung disease India registry