Pulmonary function and high-resolution CT findings in patients with an inherited form of pulmonary fibrosis, Hermansky-Pudlak syndrome, due to mutations in HPS-1
M. Brantly et al., Pulmonary function and high-resolution CT findings in patients with an inherited form of pulmonary fibrosis, Hermansky-Pudlak syndrome, due to mutations in HPS-1, CHEST, 117(1), 2000, pp. 129-136
Citations number
36
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objective: To describe and correlate pulmonary function and high-resolution
CT (HRCT) scan scores in individuals with a high risk for development of p
ulmonary fibrosis, ie, Hermansky-Pudlak syndrome (HPS) patients with mutati
ons in the HPS-I gene.
Design: Cross-sectional analysis of consecutive, eligible patients.
Patients: Thirty-eight HPS inpatients at the National Institutes of Health
Clinical Center with HPS-1 mutations.
Results: Thirty-seven patients were Puerto Rican and exhibited the typical
16-base pair (bp) duplication in exon 15 of HPS-1. One non-Puerto Rican was
homozygous for a different mutation (intervening sequence 17 -2 A --> C) p
reviously reported in the HPS-1 gene; he died at age 35 of pulmonary insuff
iciency. For the 23 patients who had pulmonary symptoms, the mean age of on
set was 35 years. For all 38 patients (mean age, 37 +/- 2 years), the mean
FVC was 71% of predicted; the mean FEV1, 76%; mean total lung capacity (TLC
), 72%; mean vital capacity (VC), 68%; and mean diffusing capacity of the l
ung for carbon monoxide (DLCO), 72%. When patients were grouped according t
o the extent of their reduction in FVC, the other four pulmonary function p
arameters followed the FVC. Seventeen patients had abnormal chest radiograp
hs, and 31 (82%) had abnormal HRCT scans of the chest, for which a scoring
system of 0 (normal) to 3 (severe fibrosis) is presented. The mean +/- SEM
HRCT score for 38 patients was 1.30 +/- 0.17. HRCT scores correlated invers
ely with FVC and DLCO.
Conclusions: Mutations in the HPS-1 gene, whether or not they involve the t
ypical 16-bp duplication seen in Puerto Rican patients, are associated with
fatal pulmonary fibrosis. In affected patients, the FVC, FEV1, TLC, VC, an
d DLCO fall in concert, and this functional deficit correlates with HRCT sc
an evidence of progression of interstitial lung disease.