Association of Clinico-radiological Profile and Pulmonary Function Status in Various Types of Diffuse Parenchymal Lung Diseases at the Time of Diagnosis

Background: Diffuse parenchymal lung diseases (DPLD) are one of the commonest causes to seek admission in the Respiratory Medicine Department and also often misdiagnosed as other diseases by general physicians due to lack of awareness.Although several studies have been done on the spectrum of various DPLDs, related work in Eastern India region are very few.Objective: To assess the clinico-radiological profile and pulmonary function status of various DPLDs during initial presentation and find out their association.Materials and methods: This is an observational, cross-sectional study done in the Respiratory Medicine Department of a tertiary care hospital.Detailed history taking and clinical examination was done in the suspected DPLD patients along with high-resolution computed tomography (HRCT) of thorax and 6-minute walk test (6MWT), spirometry, and diffusing capacity of the lung for carbon monoxide (DLCO), and statistical analysis were done to find out if any association exists among these.Results: Hypersensitivity pneumonitis (HP) and connective tissue disorders-associated diffuse parenchymal lung diseases (CTD-DPLDs) form the bulk of the study population followed by idiopathic pulmonary fibrosis (IPF).Progressive shortness of breath was the commonest symptom followed by nonproductive cough.Current Modified Medical Research Council (mMRC) grade was significantly associated with 6MWT, forced vital capacity (FVC), and DLCO values.Different HRCT patterns were significantly associated with the types of DPLD.Significant association was found between different HRCT patterns and DLCO and FVC values.Conclusion: Evaluation of the Modified Medical Research Council grade can be a simple but effective predictor of pulmonary function status.Severity of disease can be roughly estimated by recognizing different HRCT patterns.Reduced DLCO may be the first and only abnormality in early stages of DPLDs.