The clinical significance of HRCT in evaluation of patients with rheumatoid arthritis-associated interstitial lung disease: a report from China

Abstract

The objective of this study is to describe the interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients of China, and to study clinical significance of high-resolution computed tomography (HRCT) in evaluation and treatment. One hundred and ten Chinese patients (79 women and 31 man) diagnosed with RA between December 2008 to November 2009 were analyzed. According to the HRCT, 47 (42.73%) RA patients were diagnosed as ILD. Old age, smoking and pulmonary rales were closely related to ILD (P < 0.05). The main appearances of ILD were ground-glass (39.09%), honeycombing (4.55%), reticular patterns and consolidation (1.82%). Patients with reticular patterns and honeycombing were more likely to show the respiratory symptoms. It was also common to find other abnormal changes, such as fiber cord shadow (22.73%), lung markings fuzzy disorder (30%), pulmonary nodules (11.82%), emphysema (9.09%), bronchiectasis (3.64%), subpleural nodules (11.82%) and pleural thickening (24.55%). In treatment, honeycombing and subpleural nodules were more common in patients with methotrexate (MTX) and/or leflunomide treatment than without (P < 0.05). Other abnormal changes were no statistical significance (P > 0.05). Pulmonary involvement is common in RA patients, and it is suggested that HRCT could be a sensitive and useful way in evaluating the lung of RA patients.

Asymptomatic Preclinical Rheumatoid Arthritis-Associated Interstitial Lung Disease

“…In our study where the main HRCT abnormality was ground glass opacification resembling a NSIP pattern, the mean disease duration of 4.3 ± 5.7 years was similar to that reported by Biederer et al but shorter than that reported by Zou et al in a cohort of Chinese RA patients (8.25 ± 9 years) [13]. The latter discrepancy may reflect the wider range of histopathological subtypes included in the analysis of Zou et al [13], as UIP typically develops in more longstanding disease [4, 12]. …”

High-resolution CT and pulmonary function tests in rheumatoid arthritis patients with subclinical interstitial lung disease in Kuwait

“…Several studies agreed with our results; Zou et al [27], studied 110 Chinese RA patients (79 women and 31 men) and ILD was found in 47 (42.73%) according to the HRCT, however honeycombing and subpleural nodules were more common in patients on MTX. A study done by Gochuico et al [22] identified preclinical ILD in 21/64 patients (33%) having RA by HRCT.…”

Paediatric and adult bronchiectasis: Specific management with coexisting asthma, COPD, rheumatological disease and inflammatory bowel disease

“…The presence of any bronchiectasis, including by HRCT, is otherwise common in RA patients and is estimated to be between 3% and 62% as reported by a number of series of patients . Interestingly, a lower incidence appeared to be unique for Chinese patients . The demographics and severity based on the Bronchiectasis Severity Index (BSI) in the European cohorts of bronchiectasis with RA were similar to those bronchiectasis patients without RA or other causes of bronchiectasis other than COPD.…”