Pulmonary involvement in ankylosing spondylitis assessed by multidetector computed tomography

Abstract

SummaryBackgroundAnkylosing spondylitis (AS) may present with extra-articular involvement in the lungs. We aimed to evaluate the abnormal pulmonary multidetector computed tomography findings of patients with AS and compare them with the clinical symptoms, duration of illness, laboratory results and pulmonary function tests (PFT).Material/MethodsWe evaluated the chest multidetector computed tomography (MDCT) findings of 41 patients with ankylosing spondylitis (AS) and compared them with pulmonary function test (PFT) results, demographic characteristics, duration of illness and laboratory findings that we were able to obtain.ResultsThe most common abnormalities were nodules, peribronchial thickening, pleural thickening and bronchiectasis. Abnormalities occurred in 96.87% of patients in the early AS group and 77.8% of patients in the late AS group. Patients with early AS included asymptomatic individuals with normal PFT results and abnormal MDCT findings.ConclusionsThe use of MDCT in AS patients may be beneficial for the evaluation of pulmonary disease, even in asymptomatic patients without any PFT abnormalities and those in the early stages of the disease.

Rapidly Progressive Pulmonary Apical Fibrosis and Parenchymal Destruction in a Patient with Ankylosing Spondylitis

“…A retrospective analysis of lung radiographies from a large series of AS patients revealed 28 (1.3%) of 2080 patients, and most of those (25 patients) were reported to have upper lobe fibrosis. The studies which were conducted using HRCT in the later years have noted that various pleuroparenchymal manifestations were detected in 40–90% of the patients with AS [ 3 , 7 – 9 ]. In these studies, AS was not typically associated with a pattern of a classic interstitial lung disease.…”

Imaging of Cardiopulmonary Involvement in Systemic Immune-mediated Diseases

“…Pleuro-pulmonary involvement has a late onset and is usually asymptomatic. The most common radiologic pulmonary findings consist of apical fibrosis, pleural thickening, emphysema, tracheal dilatation, mosaic perfusion patterns, subpleural nodular lesions, and ILD 61…”

“…The most common radiologic pulmonary findings consist of apical fibrosis, pleural thickening, emphysema, tracheal dilatation, mosaic perfusion patterns, subpleural nodular lesions, and ILD. 61 The initial HRCT findings reflect a mild and nonspecific interstitial lung involvement, characterized by parenchymal bands, interlobular septa thickening, and pleural thickening with apical opacities and calcifications, and progressive development of multiple thin-walled or thick-walled cysts. Apical fibrosis, with or without cavitation and tractions bronchiectasis, is usually seen only in patients who have long-standing AS (15 to 20 y average duration) with severe spinal involvement, and it has been recently considered a secondary form of pleuroparenchymal fibroelastosis.…”