Lung changes in rheumatoid arthritis: CT findings.

Rémy‐Jardin, Martine; Rémy, Jacques; Cortet, Bernard; Mauri, Francesco; Delcambre, B

doi:10.1148/radiology.193.2.7972746

Cited by 242 publications

(134 citation statements)

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“…Modern studies have found symptomatic bronchiectasis with a prevalence of 2.7% in RA subjects, compared to 0.03% in the general population 2 . High resolution computed tomography (HRCT) studies demonstrate the prevalence to be much higher, with radiological BR in RA populations repeatedly reported in the region of 30% [3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co‐existent bronchiectasis

et al. 2015

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AimPatients with rheumatoid arthritis (RA) and co‐existent bronchiectasis (BRRA) have a five‐fold increased mortality compared to rheumatoid arthritis alone. Yet previous studies have found no difference in clinical and serological markers of RA disease severity between BRRA patients and RA alone. However, RA disease activity measures such as Disease Activity Score of 28 joints – C‐reactive protein (DAS28‐CRP) and anti‐cyclic citrullinated peptide antibodies (anti‐CCP) have not been studied, so we assessed these parameters in patients with BRRA and RA alone.MethodsBRRA patients (n = 53) had high‐resolution computed tomography proven bronchiectasis without any interstitial lung disease and ≥ 2 respiratory infections/year. RA alone patients (n = 50) had no clinical or radiological evidence of lung disease. DAS28‐CRP, rheumatoid factor (immunoglobulin M) and anti‐CCP were measured in all patients, together with detailed clinical and radiology records.ResultsIn BRRA, bronchiectasis predated RA in 58% of patients. BRRA patients had higher DAS28 scores (3.51 vs. 2.59), higher levels of anti‐CCP (89% vs. 46%) and rheumatoid factor (79% vs. 52%) (P = 0.003) compared to RA alone. Where hand and foot radiology findings were recorded, 29/37 BRRA (78%) and 13/30 (43%) RA alone had evidence of erosive change (P = 0.003). There were no significant differences between groups in smoking history or disease‐modifying anti‐rheumatic drug/biologic therapy.ConclusionsIncreased levels of RA disease activity, severity and RA autoantibodies are demonstrated in patients with RA and co‐existent bronchiectasis compared to patients with RA alone, despite lower tobacco exposure. This study demonstrates that BRRA is a more severe systemic disease than RA alone.

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Section: Introductionmentioning

confidence: 99%

Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co‐existent bronchiectasis

et al. 2015

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“…Differential diagnosis of exudative pleural effusion with low pH, low glucose and high LDH includes bacterial empyema, tuberculosis, malignancy, paragonimiasis and rheumatoid pleurisy (6,7). RA related pleural effusion is expected to have low glucose (<20 mg/dL), complement levels, LDH levels of >1000 U/L and pH of <7.00 (7)(8)(9)(10)(11)(12). Pleural fluid glucose to serum glucose rate was found below 0.5 in 80% of the RA patients (13).…”

Section: Discussionmentioning

confidence: 99%

A case report: Pulmonary involvement in rheumatoid arthritis

Kaya¹,

Keleş²,

Otlu³

et al. 2017

J Turgut Ozal Med Cent

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Abstract57 years old male patient, due to the increase in 15 years follow-up of RA patients under cyclosporine therapy because of complaints by the rheumatology clinic patients considered as appropriate to launch abatement was directed to us by the patient isoniazid prophylaxis. A pleural effusion was diagnosed on chest X-ray. The patient was accompanied by thoracentesis on USG. The pleural effusions were exudative. Tracking of fever, cough, sputum complaint and low acute phase reactants excluded empyema. ADA levels were under 70, and TB pleurisy was excluded by the lack of growth in ARB and culture results. The lung involvement of RA was suspected without interstitial lung disease. Rheumatoid arthritis with interstitial lung disease is the commonest form of lung involvement; the incidence of pleural effusion and nodular lesions in the form is less common. Although pleural effusion has been reported before it was thought be caused by the new biological agents for treatment of rheumatoid arthritis.

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“…El TACAR de control a las 10 semanas informó de mejoría radiológica. En la NO la TAC torácica muestra las características opacidades subpleurales en vidrio deslustrado 8 . El diagnóstico definitivo es histopatológico, en la mayoría de casos por biopsia transbronquial o videotoracoscopia, demostrándose fibroblastos en los bronquiolos y alvéolos 9 .…”

Section: Discussionunclassified

Neumonía organizada como forma de presentación de una artritis reumatoide

Temprado¹,

Manzanedo²,

Claudio³

et al. 2015

Gal. Clin.

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ResumenLa neumonía organizada (NO) es una enfermedad pulmonar intersticial que puede asociarse a la artritis reumatoide (AR). Normalmente, la afectación pulmonar se presenta tras años de evolución de las manifestaciones articulares, siendo menos frecuente la aparición concomitante de ambos procesos. Se expone el caso de una paciente de 79 años que presentó tos y disnea junto con inflamación articular y criterios serológicos de AR. La radiografía de tórax (Rx) y la tomografía axial computerizada (TAC) objetivaron un infiltrado alveolar bibasal con broncograma aéreo. Las manifestaciones pulmonares severas de una NO motivaron el ingreso y fueron la clave para el diagnóstico final de una AR. La paciente recibió tratamiento corticoideo con excelente respuesta. Palabras clave: Artritis Reumatoide, neumonía organizada, síntomas. AbstractOrganizing pneumonia (OP) is an interstitial lung disease which may be associated to rheumatoid arthritis (RA). Normally, pulmonary involvement appears after years of evolution of the joint manifestations, being the concomitant appearance of both processes less common. We present the case of a 79-year-old woman who presented with cough and dyspnea together with joint inflammation and serological criteria for RA. The thoracic X-ray and the CAT scan revealed a bibasilar alveolar infiltrate with air bronchogram. The severe pulmonary manifestations of OP caused the hospital admission and were essential for the final diagnosis of RA. The patient received treatment with corticosteroids with an excellent response. Key words: Rheumatoid Arthritis, organizing pneumonia, symptoms. IntroducciónLa AR es la artropatía inflamatoria más común, afecta al 1% de la población mundial 1 . Se caracteriza por alteraciones inflamatorias que afectan al tejido articular y estructuras relacionadas, sin embargo tiene también carácter de enfermedad sistémica con múltiples manifestaciones extrarticulares. Una de ellas es la enfermedad pulmonar intersticial (EPI), que se presenta entre el 4 y el 68% de los pacientes con AR 2 . Dentro de este grupo la forma más frecuente de presentación es la neumonía intersticial usual (NIU), seguida de la neumonía intersticial no específica (NINE) y finalmente, la neumonía organizada (NO) 3 . Lo habitual es que la afectación pulmonar se presente en fases avanzadas de la enfermedad articular, siendo más raro que la lesión pulmonar preceda o coincida con el diagnóstico de AR. Presentamos el caso de una paciente con diagnóstico de NO como primera manifestación de una AR hasta el momento no diagnosticada.

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Lung changes in rheumatoid arthritis: CT findings.

Abstract: CT may be a useful noninvasive tool for recognition of RA-associated lung disease with special emphasis on bronchial and bronchiolar changes.

Cited by 242 publications

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Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co‐existent bronchiectasis

Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co‐existent bronchiectasis

A case report: Pulmonary involvement in rheumatoid arthritis

Neumonía organizada como forma de presentación de una artritis reumatoide

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