Mosavir Ansarie, DTCD; Asif Naseem, MBBS; Aneeka Kasmani, MBBS; Rasheed Ahmed, MD; Muhammad Azeemuddin, MBBS
Background & Objective: No published data is available about the status of Interstitial Lung Diseases (ILD) in Pakistan. This study pioneers to determine the incidence and relative frequency of various ILDs in Karachi, its most populous multi-ethnic city.
Methods: We reviewed data from a registry catering to 3 pulmonology clinics in different areas of the city. Based on a detailed questionnaire it records age, gender, exposure history, clinical presentation, HRCT and PFT findings mandatorily and BAL/VATS data if available. It prospectively recorded diagnosed ILD cases between Jan 2008 and Dec 2011 and deaths occurring during follow-up.
Results: In a total of 5680 pulmonology referrals, the incidence of ILD was 2.3% (n=133) with a mean age of 55.1 years (+12.9 SD), mortality of 22.6% and median survival of 3 years. Idiopathic Pulmonary Fibrosis (IPF) (49.6%), Non Specific Interstitial Pneumonitis (NSIP) (19.5%) and Sarcoidosis (17.3%) were the most frequent ILDs followed by Collagen Vascular Disease Related (5.3%), Drug Induced ILD (4.5%) and Hypersensitivity Pneumonitis (3.8%). Reporting females (n=91) outnumbered males (n=42). The incidence of IPF/NSIP was greater in males (76%) while sarcoidosis and other ILDs occurred more in females (34%). Interestingly, out of 45 IPF diagnosed housewives living in congested areas, 42% had chronic avian exposure due to home breeding / pets.
Conclusion: The study establishes for the first time considerable presence of ILD in Pakistani population and describes its salient features. Hopefully this will improve disease awareness and help us expand this registry to other major cities for greater input towards research.