Diffuse Panbronchiolitis and Rheumatoid Arthritis: A Possible Correlation with HLA-B54.

Sugiyama, Yukihiko; Ohno, Shoji; Kano, Shogo; Maeda, Hitoshi; Kitamura, Satoshi

doi:10.2169/internalmedicine.33.612

Cited by 37 publications

(19 citation statements)

References 12 publications

(7 reference statements)

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“…The association of RA with HLA-DR4 is well established in various ethnic groups including the Japanese [18,19]. Since HLA-B54 is correlated with DR4 as an extended haplotype, both DPB and RA have the same HLA haplotype correlation which includes B54 and DR4 [20]. Therefore, it is likely that these two diseases may occur together.…”

Section: Pathogenesis Of Diffuse Panbronchiolitismentioning

confidence: 99%

Diffuse panbronchiolitis in rheumatoid arthritis

Homma¹,

Kawabata²,

Kishi³

et al. 1998

Eur Respir J

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The association of progressive obliterative bronchiolitis (OB) with rheumatoid arthritis (RA) is uncommon but has been reported previously. Diffuse panbronchiolitis (DPB) is a unique inflammation principally affecting the respiratory bronchioli and has been reported mainly in Japanese adults. Recently, DPB has also been noted in patients with RA in Japan. Therefore, there might be considerable overlap in clinical features between DPB and OB associated with RA in Japan. The aim of this study was to evaluate the clinicopathological characteristics of bronchiolitis in patients with RA. Three RA patients clinically diagnosed as having DPB were evaluated. All patients underwent chest radiographs, pulmonary function tests (PFT) and post mortem examination. Clinical features in all patients were a history of productive cough, exertional dyspnoea, wheezing and/or coarse crackles. Chest radiographs showed small nodular shadows up to 2 mm in diameter with bronchiolectasis throughout both lungs in all patients. The PFT revealed marked obstructive impairment in all patients. All patients died of progressive respiratory failure. Pathologically, two out of the three cases were confirmed as DPB, while the remaining one case was confirmed as OB, because the primary obstructive lesions were in the respiratory bronchioli in the former and in the membranous bronchioli and the proximal small bronchi in the latter. Thus, the clinical features of DPB and OB were strikingly similar, but the histopathological features revealed distinct differences. This study demonstrated that there was considerable overlap in clinical features between diffuse panbronchiolitis and obliterative bronchiolitis associated with rheumatoid arthritis, suggesting that diffuse panbronchiolitis might be a new manifestation of rheumatoid arthritis. The differentiation of these two disease entities is significant in making decisions on their therapeutic modality and is possible by analysing the precise histopathological findings of the lung.

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Section: Pathogenesis Of Diffuse Panbronchiolitismentioning

confidence: 99%

Diffuse panbronchiolitis in rheumatoid arthritis

Homma¹,

Kawabata²,

Kishi³

et al. 1998

Eur Respir J

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“…Such variability might be partially accounted for by the genetic basis of the investigated population as a function of the influence of genes, such as HLA-DR1 and HLA-DR4, on the phenotype of disease. Polymorphisms of the alleles HLA-B40 and B54 are particularly associated with lung abnormalities, fibrosis and bronchiolitis [10][11].…”

Section: Introductionmentioning

confidence: 99%

Lung affection in individuals with rheumatoid arthritis

Mstm¹,

Jvm²,

Mb³

2017

Lung Breath J

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To establish the frequency of lung affection in individuals with rheumatoid arthritis (RA) from Piaui. Participants and methods: The sample comprised 97 individuals. Results: A total of 85 participants (88.0%) were female; 77.0% were non-white; and the average age of the sample was 47.3 years old. A total of 54 participants (56.0%) exhibited extra-articular manifestations, most frequently subcutaneous nodules (19.0%). Lung assessment detected affection in 54 (55.7%) participants.

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“…Genetic polymorphisms of the HLA-B40 and B54 are associated with the presence of pulmonary changes, especially fi brosis and bronchiolitis. 4,5 In addition, some medications used in the treatment of that entity can be partially responsible for the pulmonary fi ndings in RA patients. Lefl unomide, methotrexate, and sulfasalazine have been involved in interstitial pulmonary diseases.…”

Section: Introductionmentioning

confidence: 99%