Retrospective Study of Pulmonary Function Tests in Patients Presenting With Isolated Reduction in Single-Breath Diffusion Capacity: Implications for the Diagnosis of Combined Obstructive and Restrictive Lung Disease

Aduen, Javier F.; Zisman, David A.; Mobin, Syed I.; Venegas, Carla; Francisco Alvarez; Michelle Biewend; Howard I. Jolles; Cesar A. Keller
January 2007
Mayo Clinic Proceedings;Jan2007, Vol. 82 Issue 1, p48
Academic Journal
OBJECTIVE: To examine the frequency and spectrum of diseases associated with isolated reduction in the diffusing capacity of lung for carbon monoxide (DLCO. PATIENTS AND METHODS: We retrospectively identified all potentially dyspneic patients who had pulmonary function tests (PFTs) performed at the Mayo Clinic in Jacksonville, Fla, between January 1, 1990, and June 30, 2000, that showed reduced DLCO (<70% of predicted), normal lung volumes (total lung capacity and residual volume >80% and <120% of predicted, respectively), and airflow variables (forced expiratory volume in 1 second and forced vital capacity values >80% of predicted and forced expiratory volume in 1 second/forced vital capacity ratio >70% of predicted). Only patients who had also undergone chest computed tomography (CT) and echocardiography within 1 month of PFTs were studied. RESULTS: Of the 38,095 patients who underwent PFTs during the study period, 179 (0.47%; 95% confidence interval [l), 0.40%- 0.54%) had isolated Dico abnormalities. The 27 patients (15.1%; 95% Cl, 10.2%-21.2%) who had also undergone chest CT and echocardiography within I month of PFTs form the study cohort reported herein. Their mean Dico was 50%±15% (95% Cl, 45%- 56%) with average normal pulse oxygen saturation at rest and mild hypoxemia with activity. Thirteen of the 27 patients (48%; 95% Cl, 28.7%-68.1%) had underlying emphysema evident on CT. Eleven of these 13 patIents had emphysema associated with a restrictive lung process. The 14 patients without emphysema had interstitial lung disease, pulmonary vascular disease, and other isolated findings. Six patients with combined emphysema and idiopathic pulmonary fibrosis accounted for the largest percentage (22%) of patients with isolated DLCO reduction. The mean ± SD smoking history of the 27 patients In the study cohort was 36±33 pack-years (range, 0-116 pack-years). CONCLUSION: Dyspneic patients with respiratory symptoms and normal lung volumes and airflows associated with isolated reduction in DLCO should be evaluated for underlying diseases such as emphysema, with or without a concomitant restrictive process, and pulmonary vascular disease.


Related Articles

  • Pulmonary function, CT and echocardiographic abnormalities in sickle cell disease. Lunt, Alan; Desai, Sujal R.; Wells, Athol U.; Hansell, David M.; Mushemi, Sitali; Melikian, Narbeh; Shah, Ajay M.; Thein, Swee Lay; Greenough, Anne // Thorax;Aug2014, Vol. 69 Issue 8, p746 

    Objectives: To test the hypothesis that vascular abnormalities on high-resolution CT (HRCT) would be associated with echocardiographic changes and lung function abnormalities in patients with sickle cell disease (SCD) and the decline in lung function seen in SCD patients. Methods: HRCT,...

  • Isolated DLCO Reduction: Something Serious or Nothing to Worry About? Begany, Timothy // Pulmonary Reviews;Mar2007, Vol. 12 Issue 3, p20 

    The article focuses on an investigation performed by Javier F. Aduen of the Mayo Clinic College of Medicine in Jacksonville, Florida and colleagues regarding the frequency and spectrum of diseases occurring in dyspneic patients with an isolated carbon monoxide diffusing capacity (DLCO)...

  • Computed Tomography-Based Centrilobular Emphysema Subtypes Relate with Pulmonary Function. Takahashi, Mamoru; Yamada, Gen; Koba, Hiroyuki; Takahashi, Hiroki // Open Respiratory Medicine Journal;2013, Vol. 7, p54 

    Introduction: Centrilobular emphysema (CLE) is recognized as low attenuation areas (LAA) with centrilobular pattern on high-resolution computed tomography (CT). However, several shapes of LAA are observed. Our preliminary study showed three types of LAA in CLE by CT-pathologic correlations. This...

  • Oral cyclophosphamide improves pulmonary function in scleroderma patients with fibrosing alveolitis: experience in one centre. Beretta, Lorenzo; Caronni, Monica; Raimondi, Massimo; Ponti, Alessandra; Viscuso, Tiziana; Origgi, Laura; Scorza, Raffaella // Clinical Rheumatology;Feb2007, Vol. 26 Issue 2, p168 

    Lung involvement constitutes nowadays the major cause of morbidity and mortality in scleroderma patients. Pulmonary fibrosis in systemic sclerosis (SSc) is thought to be the consequence of interstitial inflammation. Early diagnosis and treatment of active alveolitis is essential to prevent the...

  • MicroRNAs-control of essential genes: Implications for pulmonary vascular disease. Joshi, Sachindra R.; McLendon, Jared M.; Comer, Brian S.; Gerthoffer, William T. // Pulmonary Circulation;2011, Vol. 1 Issue 3, p357 

    During normal lung development and in lung diseases structural cells in the lungs adapt to permit changes in lung function. Fibroblasts, myofibroblasts, smooth muscle, epithelial cells, and various progenitor cells can all undergo phenotypic modulation. In the pulmonary vasculature occlusive...

  • Understanding Diffusing Capacity Tests.  // Pulmonology Coding Alert;Feb2012, Vol. 13 Issue 2, p10 

    The article discusses different diffusing capacity tests, including, carbon monoxide diffusing capacity and membrane diffusion capacity, which also comprize spirometry, lung volume(s), flow volume loop and airway resistance. The typical indications for testing including evaluate and follow up...

  • Microcomputer based instrument for measuring novel pulmonary function test. Craine, Brian L.; Craine, Eric R. // Review of Scientific Instruments;Aug1996, Vol. 67 Issue 8, p2910 

    Describes the design of a prototype instrument for measuring the end-tidal concentration of carbon monoxide during human respiration. Measurement of the carbon dioxide concentration using a nondispersive infrared spectrophotometer; Feature of the technology which allows for the construction of...

  • Pulmonary function in Pigeon Breeders' Disease. Schlueter, Donald P.; Fink, Jordan N.; Sosman, Abe J. // Annals of Internal Medicine;Mar69, Vol. 70 Issue 3, p457 

    Pulmonary function studies were performed in 13 patients with clinical and immunologic evidence of pigeon breeders' disease. In the nine subjects with the acute form of the disease the most consistent abnormality demonstrated was an increased residual volume. Two subjects had changes in atrial...

  • Prediction equations for single breath diffusing capacity (TIco) in a middle aged caucasian population. Thompson, B. R.; Johns, D. P.; Bailey, M.; Raven, J.; Walters, E. H.; Abramson, M. J. // Thorax;Oct2008, Vol. 63 Issue 10, p889 

    Background: There are many reference equations for the measurement of single breath carbon monoxide diffusing capacity of the lung (Tlco). However, the testing methodologies vary and there are no well documented studies that have developed reference equations for Tlco and alveolar volume (VA) in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics