Pulmonary involvement in rheumatoid arthritis: multidetector computed tomography findings

Yüksekkaya, Ruken; Çelikyay, Fatih; Yılmaz, Ayşe; Arslan, Serkan; Inanir, Ahmet; Inonu, Handan; Deniz, Çağlar

doi:10.1177/0284185113491566

Cited by 10 publications

(10 citation statements)

References 27 publications

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“…Pleural disease can include mild inflammation identified by pleural thickening on imaging, or severe inflammation with pleural effusions that can readily be identified on physical examination or imaging. Pleural disease can be identified on imaging in up to 50% of patients with classifiable RA [28]. …”

Section: Lung Disease Is Highly Prevalent In Clinically Classifiable Ramentioning

confidence: 99%

“…For example, multiple studies demonstrate HRCT is more sensitive than PFTs in the diagnosis of airways and parenchymal lung disease including studies of subjects with severe asthma as well as RA-associated ILD [30,33–34]. Further adding to this variability is the finding that the majority of lung disease in patients with RA is asymptomatic and considered ‘subclinical’ lung disease [28,32]. Specifically, in a recent study by Chen and colleagues in which HRCT was utilized, 61% of subjects wit RA (mean disease duration over 4 years) had evidence of lung disease, and 90% of those with lung disease were asymptomatic [32].…”

Section: Lung Disease Is Highly Prevalent In Clinically Classifiable Ramentioning

confidence: 99%

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The lung may play a role in the pathogenesis of rheumatoid arthritis

Demoruelle

Solomon

Fischer

et al. 2014

International Journal of Clinical Rheumatology

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Multiple studies have identified strong associations between the lung and rheumatoid arthritis (RA). Such studies identify a high prevalence of lung disease, both airways and parenchymal disease, in subjects with clinically classifiable RA. It has been suggested that lung disease in RA results from targeting of the lung from circulating autoimmunity or other factors such as medications. However, findings that lung disease, specifically inflammatory airways disease, and lung generation of autoimmunity can be present before the onset of joint symptoms suggest that immune reactions in the lung may be involved in the initial development of RA-related autoimmunity. Herein we review these issues in detail, as well as outline a potential research agenda to understand the natural history of lung involvement in RA and its relation to the overall pathogenesis of RA.

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Section: Lung Disease Is Highly Prevalent In Clinically Classifiable Ramentioning

confidence: 99%

Section: Lung Disease Is Highly Prevalent In Clinically Classifiable Ramentioning

confidence: 99%

The lung may play a role in the pathogenesis of rheumatoid arthritis

Demoruelle

Solomon

Fischer

et al. 2014

International Journal of Clinical Rheumatology

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“…RA pulmonary involvements, predominantly interstitial lung diseases, presented in 10%‐33% of patients and were believed to be the second cause of premature death in RA . Approximately 34.5% of RA patients with lung involvement were asymptomatic, suggesting that CT screening on RA patients, even on those asymptomatic or with normal pulmonary function tests is necessary . Our study found 86 (10.91%) RA patients had interstitial lung diseases, all of which were documented by positive chest CT results.…”

Section: Discussionmentioning

confidence: 58%

The incidence of extra‐articular manifestations in southern Chinese patients with inflammatory joint diseases

Yan

Zhang

et al. 2019

Int J of Rheum Dis

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Aim Inflammatory joint diseases (IJDs) are chronic arthritis, but frequently present with co‐morbidities of other organs and systems, which is known as extra‐articular manifestations (EAMs). It is still unclear which clinical characteristics or bio‐markers can predict the development of EAMs. The aim of this study was to estimate the proportion of EAMs in southern Chinese patients with IJDs and to explore the risk factors. Methods This was a retrospective cohort study of a total 1135 IJDs patients, including 788 rheumatoid arthritis (RA) patients, 307 ankylosing spondylitis (AS) patients and 40 psoriatic arthritis (PsA) patients. Demographic data, disease characteristics, laboratory blood tests, medical imaging, and the presence of EAMs were recorded. Results We found 459 (40.44%) patients presented with EAMs: 30.84% had cardiovascular involvement, 7.67% had pulmonary involvement, 5.29% had osteoporosis/low bone mineral density, 2.29% had ocular, 0.79% had gastrointestinal and 0.26% had renal involvements. Multivariate logistic regression showed older age (odds ratio [OR] 1.06, P < .001) and higher anti‐cyclic citrullinated peptide antibody (anti‐CCP) levels (OR 1.003, P = .019) were independent risks of EAMs in RA patients. In the AS group, older age (OR 1.07, P < .001) and higher disease activity (OR 3.24‐7.42, both P < .05), were independent risks of EAMs. In the PsA group, longer disease duration (OR 1.01, P = .036) and higher disease activity (OR 1.15, P = .004) were univariate associated factors. Conclusion These results suggested the high prevalence of EAMs, and it is important to regularly screen for EAMs, as they influence treatment decisions and impact on patients’ quality of life.

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“…132 The radiology in FB demonstrates bronchiolar nodularity and bronchial wall thickening, whereas in CB there is mosaic attenuation and gas trapping along with bronchial wall thickening. 133 It is often difficult to assign causality to underlying RA as patients often have preexisting diagnoses of airways disease related to cigarette smoking, asthma, occupational or drug exposures. As a result the natural history of bronchiolar disease in RA is incompletely characterized and varies from case reports of rapidly progressive CB resulting in respiratory failure and death to a recent case series reporting relative stability of the majority of their patients with OB.…”

Section: Small Airways Disease (Bronchiolitis)mentioning

confidence: 99%

Pulmonary Complications of Rheumatoid Arthritis

Farquhar

Vassallo

Edwards

et al. 2019

Semin Respir Crit Care Med

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Rheumatoid arthritis (RA) is a common chronic autoimmune disorder that characteristically causes joint inflammation and damage. In addition, many patients develop extraarticular manifestations which may cause significant comorbidity and premature mortality.Some respiratory tract involvement of the upper and lower airways and parenchymal disease features are unique to RA, including cricoarytenoid arthritis and RA pulmonary nodulosis, and others, especially the interstitial parenchymal involvement, occur in many other idiopathic and autoimmune diseases. The pathophysiology of lung disease is not well understood. Rheumatoid lung disease may even predate the onset of joint disease, and could be triggered by chronic airway and alveolar epithelial injury. Chronic systemic inflammation and risk factors such as cigarette smoking, infection, host genetics, and immune dysregulation are contributors. Treatment of the respiratory disease is directed at reducing the systemic inflammation of RA. Less well understood is the management of the interstitial lung disease of RA, for which antifibrotic and immune suppressive agents may be helpful. The management of RA-related lung disease is perhaps the major remaining hurdle in reduction of the disease burden related to extraarticular manifestations of this disease.

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Pulmonary involvement in rheumatoid arthritis: multidetector computed tomography findings

Cited by 10 publications

References 27 publications

The lung may play a role in the pathogenesis of rheumatoid arthritis

The lung may play a role in the pathogenesis of rheumatoid arthritis

The incidence of extra‐articular manifestations in southern Chinese patients with inflammatory joint diseases

Pulmonary Complications of Rheumatoid Arthritis

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