medigraphic.com

2016, Number 3

<< Back Next >>

Rev Med MD 2016; 7.8 (3)

Pulmonary affection in patients with recently diagnosed rheumatoid arthritis

Zaragoza-Valdez DL, González-Díaz V, Figueroa-Sánchez M, Ortiz-Peregrina JR, Tejeda-Andrade JC, Contreras-González U, Rivadeneyra-Macías A, Cerpa-Cruz S, Gutiérrez-Ureña SR, Martínez-Bonilla G

Language: Spanish
References: 14
Page: 130-135
PDF size: 531.33 Kb.


ABSTRACT

Introduction: Rheumatoid Arthritis (RA) has many extra articular manifestations and lungs seem to be one of the most important sites, including interstitial lung disease (ILD). RA-associated ILD is reported in 1 to 58% of patients. Previous studies have described abnormal chest x-rays in 15% of cases, diffusion capacity of lungs for carbon monoxide (DLCO) alterations from 5 to 15% and lung high resolution computed tomography (HRCT) in 80% of patients. The main goal was to determine the frequency of pulmonary affection in recently diagnosed RA and classify by DLCO and HRCT. Secondly, we want to establish a relation between laboratory and clinical characteristics, activity, spirometry and DLCO.
Material and Method: This is a transversal and descriptive study including recently patients with recent RA diagnosis. Registered data include clinical, demographic, laboratory and disease activity data, along with hands and feet x-rays, HRCT, spirometry and DLCO.
Results: 28 patients, 93% women, mean sickness duration of 1.8 years. DAS-28-CRP 2.8+ 1.11. The frequency of abnormal lung HRCT was 32% (n=8): 20% usual pattern and 12% subpleural nodules. No relation was found between DLCO, CCPA, RF, erosions and DAS-28. Tomographic abnormalities in ILD were not related to smoking, disease activity or antibodies.
Discussion: This may be one of the first studies in Mexico to evaluate the frequency of early RA-associated ILD. Based on this data we suggest routine monitoring with lung HRCT in every patient.


REFERENCES

  1. Cavagna L, Monti S, Grosso V, Boffini N, Scorletti E, Crepaldi G, et al. The multifaceted aspects of interstitial lung disease in rheumatoid arthritis. Biomed Res Int. 2013;2013:759760.

  2. 2.Pelaez-Ballestas I, Sanin LH, Moreno-Montoya J, Alvarez-Nemegyei J, Burgos-Vargas R, Garza- Elizondo M, et al. Epidemiology of the rheumatic diseases in Mexico. A study of 5 regions based on the COPCORD methodology. J Rheumatol Suppl. 2011;86:3-8.

  3. 3.Turesson C. Extra-articular rheumatoid arthritis. Curr Opin Rheumatol. 2013;25(3):360-6.

  4. 4.Dawson JK, Fewins HE, Desmond J, Lynch MP, Graham DR. Fibrosing alveolitis in patients with rheumatoid arthritis as assessed by high resolution computed tomography, chest radiography, and pulmonary function tests. Thorax. 2001;56(8):622-7.

  5. 5.Smolen JS, Breedveld FC, Eberl G, Jones I, Leeming M, Wylie GL, et al. Validity and reliability of the twenty-eight-joint count for the assessment of rheumatoid arthritis activity. Arthritis Rheum. 1995;38(1):38-

  6. 6.Gabriel SE, Crowson CS, Kremers HM, Doran MF, Turesson C, O'Fallon WM, et al. Survival in rheumatoid arthritis: a population-based analysis of trends over 40 years. Arthritis Rheum. 2003;48(1):54- 8.

  7. 7.Hamblin MJ, Horton MR. Rheumatoid arthritisassociated interstitial lung disease: diagnostic dilemma. Pulm Med. 2011;2011:872120.

  8. 8.Kelly CA, Saravanan V, Nisar M, Arthanari S, Woodhead FA, Price-Forbes AN, et al. Rheumatoid arthritis-relatedin terstitial lungdisease:associations, prognostic factors and physiological and radiological characteristics--a large multicentre UK study. Rheumatology (Oxford). 2014;53(9):1676- 82.

  9. 9.Zou YQ, Li YS, Din XN, Ying ZH. The clinical significance of HRCT in evaluation of patients with rheumatoid arthritis-associated interstitial lung disease: a report from China. Rheumatology International. 2012;32:669-673

  10. 9.Gomez H, Arraiza M, Rubio I, Garcia I. Pulmonary nodules: Presentation, methods, diagnosis and progression in reference to 5 cases. Reumatología Clínica. 2012;8(4):212-215

  11. 10.Hunninghake GW, Lynch DA, Galvin JR, Gross BH, Müller N, Schwartz D, Hogg J, et al. Radiologic findings are strongly associated with a pathologic diagnosis of usual interstitial pneumonia. Chest. 2003;124(4):1215-1223.

  12. 11.Fischer A, Solomon JJ, du Bois RM, Deane KD, Olson AL, Fernandez-Perez ER, et al. Lung disease with anti-CCP antibodies but not rheumatoid arthritis or connective tissue disease. Respir Med. 2012;106(7):1040-7.

  13. 12.Manfredsdottir VF, Vikingsdottir T, Jonsson T, Geirsson AJ, Kjartansson O, Heimisdottir M, et al. The effects of tobacco smoking and rheumatoid factor seropositivity on disease activity and joint damage in early rheumatoid arthritis. Rheumatology (Oxford). 2006;45(6):734-40.

  14. Mori S, Cho I, Koga Y, Sugimoto M. Comparison of pulmonary abnormalities on high resolution computed tomography in patients with early versus longstanding rheumatoid arthritis. Journal of Rheumatology. 2008;35(8):1513-1521




2020     |     www.medigraphic.com