Clinical and high resolution computed tomography characteristics of patients with rheumatoid arthritis lung disease

Noor, Nadiah Mohd; Said, Mohd Fuaad; Shahid, Mohd Shahdan; Manap, Roslina Abdul; Azura, Ahmad Mukari Shahizon; Shah, Shamsul Azhar

doi:10.1111/j.1756-185x.2009.01376.x

Cited by 48 publications

(10 citation statements)

References 24 publications

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“…Another possibility is that patients with RA might be physically limited by the osteoarticular involvement. Our findings are consistent with those of a recent study by Mohd Noor et al, 29 who reported that, although 92% of the 63 RA patients evaluated exhibited no dyspnea, 95% and 71% of those patients, respectively, showed lung abnormalities on PFTs and HRCT. Therefore, in patients with RA, it is not advisable to wait until symptoms develop to perform the pulmonary evaluation.…”

Section: Discussionsupporting

confidence: 93%

“…Outra possibilidade é que pacientes com AR sejam fisicamente limitados pelo acometimento osteoarticular. Nossos achados são compatíveis com os de um estudo recente realizado por Mohd Noor et al, 29 que relataram que, embora 92% dos 63 pacientes com AR avaliados não tenham apresentado dispneia, 95% e 71% desses pacientes, respectivamente, apresentaram anormalidades pulmonares nos TFP e na TCAR. Portanto, em pacientes com AR, não é aconselhável esperar até que os sintomas se desenvolvam para realizar a avaliação pulmonar.…”

Section: Discussionunclassified

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Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry

et al. 2015

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Objective: To determine whether simple diagnostic methods can yield relevant disease information in patients with rheumatoid arthritis (RA). Methods: Patients with RA were randomly selected for inclusion in a cross-sectional study involving clinical evaluation of pulmonary function, including pulse oximetry (determination of SpO2, at rest), chest X-ray, and spirometry. Results: A total of 246 RA patients underwent complete assessments. Half of the patients in our sample reported a history of smoking. Spirometry was abnormal in 30% of the patients; the chest X-ray was abnormal in 45%; and the SpO2 was abnormal in 13%. Normal chest X-ray, spirometry, and SpO2 were observed simultaneously in only 41% of the RA patients. A history of smoking was associated with abnormal spirometry findings, including evidence of obstructive or restrictive lung disease, and with abnormal chest X-ray findings, as well as with an interstitial pattern on the chest X-ray. Comparing the patients in whom all test results were normal (n = 101) with those in whom abnormal test results were obtained (n = 145), we found a statistically significant difference between the two groups, in terms of age and smoking status. Notably, there were signs of airway disease in nearly half of the patients with minimal or no history of tobacco smoke exposure. Conclusions: Pulmonary involvement in RA can be identified through the use of a combination of diagnostic methods that are simple, safe, and inexpensive. Our results lead us to suggest that RA patients with signs of lung involvement should be screened for lung abnormalities, even if presenting with no respiratory symptoms.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionunclassified

Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry

et al. 2015

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“…On high-resolution CT (HRCT), bronchiectasis has been identified in up to one third of the RA population [24,46–48]. Traction bronchiectasis seen with fibrosing RA-ILD should not be confused with freestanding bronchiectasis seen in many RA patients (Fig.…”

Section: Spectrum Of Airway Diseasementioning

confidence: 99%

Intra-thoracic rheumatoid arthritis: Imaging spectrum of typical findings and treatment related complications

Chansakul

Dellaripa

Doyle

et al. 2015

European Journal of Radiology

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Non-cardiac thoracic manifestations of rheumatoid arthritis (RA) cause significant morbidity and mortality among RA patients. Essentially all anatomic compartments in the chest can be affected including the pleura, pulmonary parenchyma, airway, and vasculature. In addition, treatment-related complications and opportunistic infections are not uncommon. Accurate diagnosis of intra-thoracic disease in an RA patient can be difficult as the radiologic findings may be nonspecific and many of these conditions may coexist. This review article serves to highlight the multitude of RA-related intra-thoracic pathological processes, emphasize differential diagnosis, diagnostic conundrums and discuss how tailoring of CT imaging and image-guided biopsy plays a key role in the management of RA-related pulmonary disease.

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“…The high incidence of pneumonia and associated mortality in patients with rheumatoid arthritis (RA) is a critical concern [1]. Airway diseases (ADs) such as bronchiectasis are common complications of RA, with a rate of 10–30% [2, 3]; patients with RA and ADs have a significantly poor prognosis [4]. Pseudomonas aeruginosa increases the risk of mortality and exacerbation in patients with bronchiectasis [4, 5]; however, the relationship between airway colonization and the incidence of pneumonia in patients with RA has not yet been clarified.…”

Section: Introductionmentioning

confidence: 99%

Pneumonia in patients with rheumatoid arthritis: effect of microbial airway colonization

Ideguchi

Yamamoto

Tahara

et al. 2021

Preprint

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Rheumatoid arthritis frequently complicates airway diseases and is associated with high rates of pneumonia and mortality. The relationship between microorganisms colonizing the lower respiratory tract and the subsequent incidence of pneumonia in patients with rheumatoid arthritis is unclear. In this study, we aimed to identify microorganisms colonizing the lower respiratory tract in patients with rheumatoid arthritis related to the risk of developing subsequent pneumonia in these patients. A retrospective cohort study was designed to include a total of 121 patients with rheumatoid arthritis (median age, 67 years; women, 78.5%) who underwent bronchoscopy at three hospitals from January 2008 to December 2017. The following information was extracted from their electronic medical records: patient characteristics, microorganisms detected by bronchoscopy, and subsequent incidences of pneumonia. The patients were divided into groups based on the microorganisms isolated from the lower respiratory tract and compared with control subjects. The cumulative incidence of pneumonia was assessed using the Kaplan-Meier method and log-rank test. Risk factors for pneumonia were analyzed using the Cox proportional-hazards analysis. The most frequently isolated microbes from the lower respiratory tract in descending order were Pseudomonas aeruginosa, Staphylococcus aureus, and Haemophilus influenzae. The annual incidence rates of pneumonia per 1000 patients were 100, 62, 132, and 38, in the P. aeruginosa, S. aureus, H. influenzae, and control group, respectively. Patients colonized with P. aeruginosa had a higher frequency of macrolide use and a higher degree of bronchiectasis than patients in the control group. The rate of the subsequent incidence of pneumonia was higher in the P. aeruginosa group (P = 0.038), and P. aeruginosa was an independent risk factor for pneumonia (hazard ratio, 3.504; 95% confidence interval, 1.153-10.330). The colonization of the lower respiratory tract by P. aeruginosa in patients with rheumatoid arthritis was associated with the subsequent incidence of pneumonia.

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Clinical and high resolution computed tomography characteristics of patients with rheumatoid arthritis lung disease

Cited by 48 publications

References 24 publications

Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry

Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry

Intra-thoracic rheumatoid arthritis: Imaging spectrum of typical findings and treatment related complications

Pneumonia in patients with rheumatoid arthritis: effect of microbial airway colonization

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