PT - JOURNAL ARTICLE AU - Yuji Yamamoto AU - Kazuyuki Tsujino AU - Tomoki Kuge AU - Fukuko Okabe AU - Takahiro Kawasaki AU - Takanori Matsuki AU - Hiroyuki Kagawa AU - Mari Miki AU - Keisuke Miki AU - Masahide Mori AU - Hiroshi Kida TI - Pleuroparenchymal fibroelastosis in <em>Mycobacterium avium</em> complex pulmonary disease: Clinical characteristics and prognostic impact AID - 10.1183/23120541.00765-2020 DP - 2020 Jan 01 TA - ERJ Open Research PG - 00765-2020 4099 - http://openres.ersjournals.com/content/early/2020/11/26/23120541.00765-2020.short 4100 - http://openres.ersjournals.com/content/early/2020/11/26/23120541.00765-2020.full AB - The association between Mycobacterium avium complex pulmonary disease (MAC-PD) and pleuroparenchymal fibroelastosis (PPFE) has been reported previously, and interstitial pneumonia as a comorbidity is associated with a worse prognosis. However, no study has thoroughly reported on PPFE associated with MAC-PD. The present study investigated the prevalence, clinical characteristics, and prognostic impact of PPFE in patients with MAC-PD.A total of 224 patients, newly diagnosed with MAC-PD, were retrospectively reviewed. At the time of diagnosis, chest high-resolution computed tomography (HRCT), sputum examination, and clinical characteristics were collected. The extent of PPFE and MAC-PD were evaluated semi-quantitatively using HRCT scores. Risk factor analysis for clinical or radiological deterioration necessitating multidrug antimicrobial treatment within 3 years, and all-cause mortality within 5 years, from the initial diagnosis was performed based on the PPFE score.PPFE was observed in 59/224 patients (26.3%). A higher PPFE score was a risk factor for dyspnea, fatigue, and lower body mass index (BMI) (p&lt;0.05). Although PPFE score did not correlate with clinical or radiological deterioration within 3 years (p=0.576), a higher PPFE score (adjusted odds ratio (OR) 1.66, 95% confidence interval (CI) 1.06–2.60, p=0.028) and lower BMI (adjusted OR 0.61, 95% CI 0.39–0.94, p=0.028) increased the risk of 5-year mortality.PPFE is a relatively common complication and an independent poor prognostic factor of MAC-PD. This study highlights the need for further studies investigating whether the presence of PPFE can be a clinical indicator for initiating treatment of MAC-PD.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Yamamoto has nothing to disclose.Conflict of interest: Dr. Tsujino has nothing to disclose.Conflict of interest: Dr. Kuge has nothing to disclose.Conflict of interest: Dr. Okabe has nothing to disclose.Conflict of interest: Dr. Kawasaki has nothing to disclose.Conflict of interest: Dr. Matsuki has nothing to disclose.Conflict of interest: Dr. Kagawa has nothing to disclose.Conflict of interest: Dr. Miki has nothing to disclose.Conflict of interest: Dr. Miki has nothing to disclose.Conflict of interest: Dr. Mori has nothing to disclose.Conflict of interest: Dr. Kida has nothing to disclose.