Interstitial lung abnormalities a risk factor for rheumatoid arthritis interstitial lung disease progression: what's new

Abstract

@ERSpublications ILA/ILD extension and subpleural ILA localisation are risk factors for disease progression in RA subjects. A semiquantitative method to assess ILA/ILD extent and to measure the fibrotic burden is feasible to accurately determine ILA progression. https://bit.ly/3mmMJk2 Context The attention given to interstitial lung abnormalities (ILAs) by the scientific community is constantly growing. ILA may or may not progress to a clinically significant interstitial lung disease (ILD). However, ILA radiological progression has been proved to be connected to worse clinical outcomes (increased pulmonary function decline and risk of death) [1, 2]. Recently a Fleischner Society position paper proposed a strategy to both monitor and manage ILAs [3]. Rheumatoid arthritis (RA) is a connective tissue disease in which pulmonary involvement is common [4]. Individuals with RA-ILD show a poor prognosis [5], worse than RA patients without ILD. An important prognostic factor in RA-ILD is the radiological pattern, with a usual interstitial pneumonia pattern identified as independent predictor of mortality [6]. However, we are dealing with the tip of an iceberg, since there are still several undiagnosed cases of pulmonary involvement, due to their pauci-symptomatic nature. ILAs, according to previous studies, seem to be present in the 20-60% of RA patients [4, 7, 8]. Kawano et al. [9] focused their attention not only on the clinically evident RA-ILD, but also on RA-ILA trying to measure its prevalence and determine the risk factors for its progression.

Serum sCD25 is an indicator for rheumatoid arthritis-associated interstitial lung disease

“…The evaluation of interstitial lung disease was made according to chest HRCT, all enrolled horizontal subjects underwent chest HRCT scans, and the results was blindly evaluated by one respiratory surgeon and two radiologists (25). According to the HRCT, the most common patterns of RA-ILD are usual interstitial pneumonia (UIP), non-specific interstitial pneumonia (NSIP) (7), interstitial lung abnormality (ILA) is defined as previous indicated CT findings (10,(26)(27)(28). UIP pattern was defined as reticular abnormality, honeycombing and traction bronchiectasis, the abnormality is usually basal and peripheral predominance.…”