Several high-resolution computed tomography findings associate with survival and clinical features in rheumatoid arthritis-associated interstitial lung disease

Nurmi, Hanna; Kettunen, Hannu-Pekka; Suoranta, Sanna-Katja; Purokivi, Minna; Kärkkäinen, Miia; Selander, Tuomas; Kaarteenaho, Riitta

doi:10.1016/j.rmed.2017.11.013

Cited by 58 publications

(50 citation statements)

References 27 publications

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“…Radiological findings in RA-ILD include ground glass-opacities, reticulation, consolidation, honeycombing, and nodules similar to other ILD subtypes [30,33,38,39]. The most common HRCT patterns in RA-ILD are UIP and NSIP, while organizing pneumonia (OP) and bronchiolitis are less common ( Figure 1) (Table 1) [8,14,[38][39][40][41][42][43][44][45][46][47]. Studies show a fairly good correlation between HRCT and histopathological findings with the least concordance in the diagnosis of UIP and NSIP [39,42,46].…”

Section: Imagingmentioning

confidence: 99%

Interstitial Lung Disease in Rheumatoid Arthritis Remains a Challenge for Clinicians

Bendstrup

Møller

Kronborg-White

et al. 2019

JCM

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Interstitial lung disease (ILD) is a serious complication of rheumatoid arthritis (RA) contributing to significantly increased morbidity and mortality. Other respiratory complications, such as chronic obstructive pulmonary disease and bronchiectasis, are frequent in RA. Infections and drug toxicity are important differential diagnoses and should be considered in the diagnostic work-up of patients with RA presenting with respiratory symptoms. This review provides an overview of the epidemiology and pathogenesis of RA-ILD, the radiological and histopathological characteristics of the disease as well as the current and future treatment options. Currently, there is no available evidence-based therapy for RA-ILD, and immunosuppressants are the mainstay of therapy. Ongoing studies are exploring the role of antifibrotic therapy in patients with progressive fibrotic ILD, which may lead to a new treatment approach for subgroups of patients with RA-ILD.

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Section: Imagingmentioning

confidence: 99%

Interstitial Lung Disease in Rheumatoid Arthritis Remains a Challenge for Clinicians

Bendstrup

Møller

Kronborg-White

et al. 2019

JCM

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“…113 When compared with the other CTD, rheumatoid arthritis-associated ILD (RA-ILD) is more commonly associated with a UIP pattern, but NSIP can also be seen. [114][115][116] Irrespective of which CTD is involved, clinicians should note that an ILD can present as the first clinical feature of an underlying CTD. A previous retrospective study has reported almost one-third of consecutive ILD patient satisfied published criteria for an underlying CTD that was unrecognized during the initial assessment.…”

Section: Ctd-ildmentioning

confidence: 99%

Nonspecific Interstitial Pneumonia

Teoh

Corte

2020

Semin Respir Crit Care Med

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Nonspecific interstitial pneumonia (NSIP) is a complex disorder commonly associated with other conditions such as connective tissue diseases (CTDs) and environmental exposures. Although idiopathic NSIP has been recognized as a separate clinical entity, recent studies have suggested that a proportion of these cases have autoimmune features suggestive of underlying CTDs. The diagnosis of NSIP usually carries a better prognosis compared with idiopathic pulmonary fibrosis but has an unpredictable natural history. Its pathogenesis is thought to be an inflammatory-driven process involving multiple pathways, including a genetic predisposition. The lack of specific clinical features often makes the diagnosis of NSIP difficult. The huge variability of radiological and histological features seen in NSIP adds to the complexity of achieving an accurate diagnosis of NSIP and a multidisciplinary approach is often required. There is a lack of consensus on the optimal management strategy of NSIP. Early clarification of the goals of therapy and close monitoring for the progression of disease is important across the spectrum of NSIP irrespective of its etiology. Although immunosuppressive and immunomodulatory agents are commonly used for severe and progressive disease, the therapeutic landscape of NSIP is constantly evolving as the role of newer agents such as antifibrotic therapies is being explored.

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“…19 Risk factors for ILD in RA include male sex, older age, smoking history, presence of rheumatoid factor, 19 and ACCPA. 20 The majority of patients with RA-ILD exhibit a usual interstitial pneumonia (UIP) morphology, 21 characterized on HRCT by basal predominant subpleural reticulation, with or without honeycombing (►Fig. 1).…”

Section: Parenchymal Diseasementioning

confidence: 99%

“…16 Of patients with RA and non-UIP ILD, a nonspecific interstitial pneumonia (NSIP) or unclassifiable HRCT morphologies are the next most common phenotypes, being present in around 10 to 15% of patients. 21,25,26 Fibrotic organizing pneumonias (OPs), lymphocytic interstitial pneumonias, and desquamative interstitial pneumonias (DIPs) are rare. 25 Rheumatoid pneumoconiosis (Caplan's syndrome) represents a characteristic HRCT morphology of fibrosis which occurs in the context of RA and occupational dust-related pneumoconiosis.…”

Section: Parenchymal Diseasementioning

confidence: 99%

Computed Tomographic Imaging in Connective Tissue Diseases

Devaraj

Wells

Hansell³

2019

Semin Respir Crit Care Med

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Pulmonary disease represents a significant extra-articular manifestation in the majority of connective tissue diseases (CTDs). The identification, classification, and staging of pulmonary involvement are centrally important to the management of patients, aiding the prognostication of disease behavior and treatment decisions. We present a review of the high-resolution computed tomographic pulmonary features of CTD in the lung and their significance to the reporting radiologist.

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Several high-resolution computed tomography findings associate with survival and clinical features in rheumatoid arthritis-associated interstitial lung disease

Abstract: Many radiological findings associate with the course of the disease of RA-ILD and could potentially be useful when planning the RA treatment or evaluating the risk of death in these patients.

Cited by 58 publications

References 27 publications

Interstitial Lung Disease in Rheumatoid Arthritis Remains a Challenge for Clinicians

Interstitial Lung Disease in Rheumatoid Arthritis Remains a Challenge for Clinicians

Nonspecific Interstitial Pneumonia

Computed Tomographic Imaging in Connective Tissue Diseases

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