Visual Assessment of Chest Computed Tomography Findings in Anti-cyclic Citrullinated Peptide Antibody Positive Rheumatoid Arthritis: Is it Associated with Airway Abnormalities?

Park, Won Hong; Kim, Song Soo; Shim, Seung Cheol; Song, Seung Hwan; Jung, Sung Soo; Kim, Jin Hwan; Kim, Namkug; Seo, Joon Beom

doi:10.1007/s00408-015-9828-1

Cited by 11 publications

(9 citation statements)

References 42 publications

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“…Our cases with available pathological findings showed NSIP with or without lymphoid follicles, and previous case reports also showed the same (Table 2) (13,14). On the other hand, high ACPA titer was significantly associated with small airway disease in RA subjects (18). Although only 1 patient (case 3) showed cellular bronchiolitis with ILD, coexistence of small airway disease and ILD may be meaningful in ACPA-positive ASS patients.…”

Section: Discussionsupporting

confidence: 84%

“…NSIP + OP was identified when consolidations were superimposed on a background of ground-glass opacity (GGO) with or without reticulations or traction bronchiectasis (16). HRCT findings were analyzed from each of the characteristic viewpoints of ACPA-positive ILD (i.e., honeycombing, centrilobular nodules, bronchial wall thickening, and expiratory air trapping) and ILD associated with ASS (i.e., lower lung volume loss and lower lung predominance) referring to previous reports (9,10,16,18,19). These HRCT findings were interpreted according to the recommendations of the Fleischner Society (20).…”

Section: Study Methodsmentioning

confidence: 99%

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Interstitial lung disease associated with anti-citrullinated peptide/protein antibody-positive anti-synthetase syndrome

Yamakawa¹,

Hagiwara²,

Iwasawa³

et al. 2018

J. Thorac. Dis

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Little has been reported on the characteristics of interstitial lung disease (ILD) associated with anti-citrullinated peptide/protein antibody (ACPA)-positive anti-synthetase syndrome (ASS). We sought to investigate the clinical, radiologic, and pathologic features of patients with ILD associated with ACPApositive ASS. Medical records of seven ILD patients with positive results of both ACPA and anti-aminoacyl-tRNA synthetase antibody were retrospectively reviewed. Five patients had clinical symptoms associated with ASS other than ILD. On high-resolution computed tomography (HRCT) analysis, a nonspecific interstitial pneumonia (NSIP) pattern was shown in 3 patients and NSIP with organizing pneumonia (OP) overlap in 2 patients. Coronal slices of these 5 patients showed lower lung disease predominance with traction caudally on major fissures due to lower lobe volume loss. These were features that could commonly be observed in ASS-associated ILD. Pathological findings available for 3 patients showed NSIP. The characteristics of ILD associated with ACPA-positive ASS appear to be similar to those of ILD associated with ASS, but not to rheumatoid arthritis (RA) or ACPA, especially in terms of the radiological findings.

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Section: Discussionsupporting

confidence: 84%

Section: Study Methodsmentioning

confidence: 99%

Interstitial lung disease associated with anti-citrullinated peptide/protein antibody-positive anti-synthetase syndrome

Yamakawa¹,

Hagiwara²,

Iwasawa³

et al. 2018

J. Thorac. Dis

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“…Using FEF 25–75% as a marker of SAD in RA, a recent study showed no association of this parameter with RF or anti-CCP (which are the biomarkers most used in the diagnosis and prognosis of RA in clinical practice) [20]. Interestingly, Park et al [26] demonstrated an association between anti-CCP positivity and small airway abnormalities evaluated by CT. However, it is important to note that smoking itself increases protein citrullination, leading to higher anti-CCP production in individuals with RA [27].…”

Section: Discussionmentioning

confidence: 99%

Does the nitrogen single-breath washout test contribute to detecting pulmonary involvement in rheumatoid arthritis? A pilot study

et al. 2019

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ObjectiveThere has been growing interest in studying small airway disease through measures of ventilation distribution, thanks to the resurgence of the nitrogen single-breath washout (N2SBW) test. Therefore, this study evaluated the contribution of the N2SBW test to the detection of pulmonary involvement in patients with rheumatoid arthritis (RA).ResultsTwenty-one patients with RA underwent clinical evaluation, pulmonary function tests (PFTs), including the N2SBW test, and computed tomography (CT). The main tomographic findings were air trapping and bronchiectasis (57.1% and 23.8% of cases, respectively). According to the phase III slope of the N2SBW (phase III slope), 11 and 10 patients had values < 120% predicted and > 120% predicted, respectively. Five patients with limited involvement on CT had a phase III slope > 120%. The residual volume/total lung capacity ratio was significantly different between patients with phase III slopes < 120% and > 120% (P = 0.024). Additionally, rheumatoid factor positivity was higher in patients with a phase III slope > 120% (P = 0.021). In patients with RA and airway disease on CT, the N2SBW test detects inhomogeneity in the ventilation distribution in approximately half of the cases, even in those with normal conventional PFT results.

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“…29 In contrast to the findings of Izumiyama et al, 29 other studies found that female gender was significantly associated with BE in these RA patients (p = 0.043), while also finding a significant correlation with longer disease duration (OR = 1.05 95% CI: 1.007–1.095, p = 0.023), 27 but no association with any antibody titres and BE development. 39 In the study by McMahon et al 6 in 1993 they found essentially no differences in disease severity and antibody titres between patients with RA and BE compared to patients with RA alone. The lack of differences between the two groups is contradictory to later findings but might be explained by the relatively small group consisting of only 64 patients.…”

Section: Discussionmentioning

confidence: 95%

A causal relationship between rheumatoid arthritis and bronchiectasis? A systematic review and meta-analysis

2021

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Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints but often also associated with lung involvement such as bronchiectasis (BE). The aim of the present systematic review and meta-analysis is to provide an update on the current evidence regarding the prevalence and association between RA and BE. This systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines with literature search using the terms ‘Bronchiectasis AND Rheumatoid Arthritis’ without a date limitation on PubMed during May 2020. A total of 28 studies fulfilled the predefined criteria and were included in the present review, with 19 being cross-sectional studies. Twenty-three studies were included in the meta-analysis. The pooled prevalence estimate was 2.69% (95% CI 1.63–4.42) in clinically defined BE, and 24.9% (95% CI 19.21–31.67) in radiologic disease. Many inconsistencies exist regarding potential risk factors for BE in RA patients such as gender, RA duration and severity, as both negative and positive associations have been reported. Although very little is known about possible causative mechanisms between RA and BE, potential pathways might be antigenic stimulation from pulmonary mucus and/or systemic inflammation from joint disease affecting the lungs. At present, the available evidence of bronchiectasis in patients with RA is insufficient to identify RA-associated risk factors for the development of BE, possibly apart from duration of RA, and, consequently, also to fully explore a possible causal relationship between the two disease. However, the increased prevalence of BE in RA patients warrants further studies to explore the association between RA and BE.

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Visual Assessment of Chest Computed Tomography Findings in Anti-cyclic Citrullinated Peptide Antibody Positive Rheumatoid Arthritis: Is it Associated with Airway Abnormalities?

Abstract: In ACCPA (+) RA, visual CT assessment of large and small airways beyond RA-ILD, which is attributable to RA-related autoimmunity, can provide valuable information regarding airway abnormalities, regardless of the patients' physiologic airflow limitations.

Cited by 11 publications

References 42 publications

Interstitial lung disease associated with anti-citrullinated peptide/protein antibody-positive anti-synthetase syndrome

Interstitial lung disease associated with anti-citrullinated peptide/protein antibody-positive anti-synthetase syndrome

Does the nitrogen single-breath washout test contribute to detecting pulmonary involvement in rheumatoid arthritis? A pilot study

A causal relationship between rheumatoid arthritis and bronchiectasis? A systematic review and meta-analysis

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