Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 20;24(1):28.
doi: 10.3390/ijms24010028.

Lung Damage in Rheumatoid Arthritis-A Retrospective Study

Georgiana Dinache  1   2 , Claudiu Costinel Popescu  1   2 , Corina Mogoșan  1   2 , Luminita Enache  1   2 , Mihaela Agache  1   2 , Cătălin Codreanu  1   2
Affiliations

Lung Damage in Rheumatoid Arthritis-A Retrospective Study

Georgiana Dinache et al. Int J Mol Sci. .

Abstract

The current study aimed to evaluate rheumatoid arthritis (RA) patients with interstitial lung disease (ILD) in clinical practice and whether disease characteristics are associated with X-ray and high-resolution computed tomography (HR-CT) findings. Medical history of RA patients from a tertiary rheumatology clinic was retrieved from its electronic database starting from 1 January 2019 until the study date (8 August 2022) using International Classification of Disease version 10 codes for RA, ILD and exclusion criteria. The study included 78 RA patients (75.6% women, 15.4% active smokers), with average time from RA to ILD of 5.6 years. Regarding chest X-ray findings, men had a higher prevalence of nodules, combined fibrosis and nodules and combined bronchiectasis and nodules, rheumatoid factor (RF)-positive patients had a higher prevalence of fibrosis and anti-cyclic citrullinated peptide antibodies (ACPA)-positive patients had a higher prevalence of bronchiectasis. Regarding HR-CT findings, patients actively treated with methotrexate had a higher prevalence of nodules; a combination of fibrosis and nodules; combination of emphysema and nodules; and combination of fibrosis, emphysema and nodules. ILD develops within approximately 5 years from RA diagnosis, and ILD-associated imaging findings on chest X-rays and HR-CT are more prevalent among men with RA, among patients with positive RA serology (RF and/or ACPA) and RA patients on methotrexate.

Keywords: interstitial pulmonary fibrosis; pulmonary nodules; rheumatoid arthritis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Radiographic ILD in a 71-year-old woman with seropositive RA showing diffuse interstitial fibrosis with bilateral reticular and areolar pattern (“honeycomb”) on (a) anteroposterior view and on (b) left lateral view.
Figure 2
Figure 2
HR-CT scan of the same patient (cross-sections) showing bilateral moderately severe “honeycomb” fibrosis (red arrows) in an “usual interstitial pneumonia” pattern: (a) predominantly peripheral interstitial changes; (b) basal subpleural disposition of fibrosis thickened septa.
See this image and copyright information in PMC

References

    1. Lee H.K., Kim D.S., Yoo B., Seo J.B., Rho J.Y., Colby T.V., Kitaichi M. Histopathologic pattern and clinical features of rheumatoid arthritis-associated interstitial lung disease. Chest. 2005;127:2019–2027. doi: 10.1378/chest.127.6.2019. - DOI - PubMed
    1. Travis W.D., Costabel U., Hansell D.M., King T.E., Jr., Lynch D.A., Nicholson A.G., Ryerson C.J., Ryu J.H., Selman M., Wells A.U., et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am. J. Respir. Crit. Care Med. 2013;188:733–748. doi: 10.1164/rccm.201308-1483ST. - DOI - PMC - PubMed
    1. Charles P.J., Sweatman M.C., Markwick J.R., Maini R.N. Maini. HLA-B40: A marker for susceptibility to lung disease in rheumatoid arthritis. Dis. Markers. 1991;9:97–101. - PubMed
    1. Hillarby M.C., McMahon M.J., Grennan D.M., Cooper R.G., Clarkson R.W.E., Davies E.J., Sanders P.A., Chatitopadhyay C., Swinson D. HLA associations in subjects with rheumatoid arthritis and bronchiectasis but not with other pulmonary complications of rheumatoid disease. Br. J. Rheumatol. 1993;32:794–797. doi: 10.1093/rheumatology/32.9.794. - DOI - PubMed
    1. Scott T.E., Wise R.A., Hochberg M.C., Wigley F.M. HLA-DR4 and pulmonary dysfunction in rheumatoid arthritis. Am. J. Med. 1987;82:765–771. doi: 10.1016/0002-9343(87)90013-1. - DOI - PubMed