Retrospective study of the clinical characteristics and risk factors of rheumatoid arthritis-associated interstitial lung disease

Abstract

This study aims to explore the clinical characteristics and risk factors of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD). This is a retrospective study of 550 patients with RA. All patients underwent chest high-resolution computed tomography (HRCT) scanning. (1) Two hundred thirty-seven out of five hundred fifty (43.1%) patients with RA were diagnose with ILD. 13.5% ILD occurred before RA onset, 69.6% ILD occurred within 10 years of RA onset, and 16.9% ILD occurred more than 10 years after RA onset. (2) The most common chest CT characteristics of RA-ILD included reticular patterns (57.8%), pleural thickening (57%), ground-glass attenuation (53.2%), followed by interlobular septum thickening, nodules, emphysematous bullae, honeycombing, and bronchiectasis. The proportion of the UIP pattern and NSIP on HRCT was 18.6% and 57.8%. (3) RA-ILD was often associated with other lung lesions, including pleural disease, bronchiectasis, and pulmonary hypertension. (4) the comparisons between RA with ILD and RA without ILD showed that male, smoking, age, disease duration, number of swelling joints, globulin levels, erythrocyte sedimentation rate, C-reactive protein levels, lactate dehydrogenase, the positive rate of rheumatoid factor (RF) and the absolute value of RF, forced vital capacity, forced expiratory volume in 1 s, and carbon monoxide diffusion rate, were statistically different (P < 0.05). Logistic regression analysis showed that age, smoking, elevated lactate dehydrogenase, and RF positive were closely correlated to RA-ILD. RA-ILD occurs more often within 10 years of RA onset and coexists with other lung lesions. The elevated lactate dehydrogenase, RF positive, smoking, and advanced age are closely correlated with RA-ILD.

Fibrocyte measurement in peripheral blood correlates with number of cultured mature fibrocytes in vitro and is a potential biomarker for interstitial lung disease in Rheumatoid Arthritis

“…This result is consistent with a recent and major retrospective study on 550 RA patients, which found that 43% of these patients had or were about to develop RA-ILD [35]. In the study, the RA-ILD diagnosis was based on HRCT, and patients with RA-ILD had a significantly and expected DLCO reduction compared to other RA patients.…”

Rituximab therapy in interstitial lung disease associated with rheumatoid arthritis

“…Olson et al . reported that 10% of RA patients developed ILD before the occurrence of the rheumatological syndrome and our data (ranging from 10 to 13.5%) are in line with these findings . Regarding the presence and levels of anti‐CCP antibody, a subgroup of patients presented positive anti‐CCP at the time of ILD diagnosis.…”

“…Olson et al 1 reported that 10% of RA patients developed ILD before the occurrence of the rheumatological syndrome and our data (ranging from 10 to 13.5%) are in line with these findings. 30 Regarding the presence and levels of anti-CCP antibody, a subgroup of patients presented positive anti-CCP at the time of ILD diagnosis. Kelly's study reported a cut-off value of 180 U/L for high risk of developing ILD in RA patients, 6 while Mori et al suggested a value >100 IU/L.…”

Interstitial Lung Disease and Other Pulmonary Manifestations in Connective Tissue Diseases

“…Middle-aged men; those with a smoking history of greater than 25 pack-years, who are positive for rheumatoid factor or anticitrullinated peptide antibodies; those with other extra-articular disease manifestations; and those with the human leukocyte antigeneantigen Derelated double-shared epitope are at particular risk for the development of RA-ILD. 52,54 The most common pattern of RA-ILD is UIP in most series of patients in Western countries. However, a study from China reported that 58% of 237 patients with RA-ILD had an NSIP pattern on HRCT.…”