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interstitial lung disease in rheumatoid arthritis

Fabrizio Pancaldi, Marco Sebastiani, Giulia Cassone, Fabrizio Luppi, Stefania Cerri, Giovanni Della Casa, Andreina Manfredi
The diagnosis of interstitial lung diseases in patients affected by rheumatoid arthritis is fundamental to improving their survival rate. In particular, the average survival time of patients affected by rheumatoid arthritis with pulmonary implications is approximately 3 years. The gold standard for confirming the diagnosis of this disease is computer tomography. However, it is very difficult to raise diagnosis suspicion because the symptoms of the disease are extremely common in elderly people. The detection of the so-called velcro crackle in lung sounds can effectively raise the suspicion of an interstitial disease and speed up diagnosis...
March 9, 2018: Computers in Biology and Medicine
Elizabeth F Redente, Martin A Aguilar, Bart P Black, Benjamin Edelman, Ali Bahadur, Stephen M Humphries, David A Lynch, Lutz Wollin, David W H Riches
Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) develops in approximately 20% of patients with RA. SKG mice, which are genetically prone to developing autoimmune arthritis, develop a pulmonary interstitial pneumonia that resembles human cellular and fibrotic non-specific interstitial pneumonia. Nintedanib, a tyrosine kinase inhibitor approved for the treatment of idiopathic pulmonary fibrosis, has been shown to reduce lung function decline. Therefore, we investigated the effect of nintedanib on the development of pulmonary fibrosis and joint disease in female SKG mice with arthritis induced by intraperitoneal injection of zymosan (5 mg)...
March 15, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
K Krüger
Due to therapeutic advances, rheumatoid arthritis (RA) today has developed into a satisfactorily treatable disease in most cases, with remission being the target of treatment. Early diagnosis with immediate treatment initiation following treat-to-target strategy is the key to a favorable long-term outcome. A guideline-directed treatment algorithm determines the use of conventional synthetic disease-modifying anti-rheumatic drugs (DMARD; e.g., methotrexate), biological DMARD, and targeted oral DMARD (Janus kinase inhibitors)...
March 5, 2018: Der Internist
Alessia Alunno, Onelia Bistoni, Federico Pratesi, Giuliana Maria Concetta La Paglia, Ilaria Puxeddu, Paola Migliorini, Roberto Gerli
Objectives: RA is an articular chronic inflammatory disease that in a subgroup of patients can also present with extra-articular manifestations (EAMs). Despite intense investigation on this topic, reliable biomarkers for EAMs are lacking. In recent years several ACPAs, including those targeting anti-citrullinated alpha enolase peptide-1 (anti-CEP-1), have been identified in patients with RA. Data about the ability of anti-CEP-1 to predict the development of erosive disease are confliciting and no evidence concerning their possible association with EAMs in RA is currently available...
February 14, 2018: Rheumatology
Yuhei Ito, Machiko Arita, Shogo Kumagai, Reoto Takei, Maki Noyama, Fumiaki Tokioka, Keisuke Nishimura, Takashi Koyama, Hiromasa Tachibana, Tadashi Ishida
Objectives High-resolution computed tomography (HRCT) parenchymal patterns have been used to predict prognosis in patients with interstitial lung disease (ILD). In idiopathic pulmonary fibrosis, the fibrosis score (i.e., the combined extent of reticulation and honeycombing) has been associated with worse survival. This study aimed to identify HRCT patterns and patient characteristics that can predict poor prognosis in rheumatoid arthritis-related ILD (RA-ILD). Methods We retrospectively analysed 65 patients with newly diagnosed RA-ILD from 2007 to 2016 at Kurashiki Central hospital...
February 15, 2018: Modern Rheumatology
Xin Wang, Qin Zhao, Zhao-da Deng, Xiao-Yuan Wang, Si-Gong Zhang, Hai-Li Shen
During choosing non-steroidal anti-inflammatory drugs(NSAIDs), risk factors should be evaluated in elder patients with rheumatoid arthritis. The present study focused on biological therapies, and elderly patients should be more concerned about the risk of infection when used it. Traditional Chinese medicine has advantages of obvious curative effect, especially for tripterygium wilfordii, large clinical trial on western and Chinese medical accurate drug strategies for old patients with rheumatoid arthritis. Old patients are easier to suffer from cardiac diseases and interstitial lung disease, rheumatoid arthritis could be controlled along with the treatment for coexistent disease...
June 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Carlos Fernández-Díaz, Javier Loricera, Santos Castañeda, Raquel López-Mejías, Clara Ojeda-García, Alejandro Olivé, Samantha Rodríguez-Muguruza, Patricia E Carreira, Trinidad Pérez-Sandoval, Miriam Retuerto, Evelin C Cervantes-Pérez, Bryan J Flores-Robles, Blanca Hernández-Cruz, Ana Urruticoechea, Olga Maíz-Alonso, Luis Arboleya, Gema Bonilla, Íñigo Hernández-Rodríguez, Desirée Palma, Concepción Delgado, Rosa Expósito-Molinero, Ana Ruibal-Escribano, Belén Álvarez-Rodríguez, Juan Blanco-Madrigal, José A Bernal, Paloma Vela-Casasempere, Manuel Rodríguez-Gómez, Concepción Fito, Francisco Ortiz-Sanjuán, Javier Narváez, Manuel Moreno, Mireia López-Corbeto, Natalia Mena-Vázquez, Clara Aguilera-Cros, Susana Romero-Yuste, Sergi Ordóñez, Ignacio Villa-Blanco, M Carmen Gonzélez-Vela, Víctor Mora-Cuesta, Natalia Palmou-Fontana, José L Hernández, Miguel A González-Gay, Ricardo Blanco
OBJECTIVE: Interstitial lung disease (ILD) is one of the most serious complications of rheumatoid arthritis (RA). In the present study, we aimed to assess the efficacy of abatacept (ABA) in patients with ILD associated to RA. METHODS: National multicenter, non-controlled, open-label registry study of RA patients with ILD treated with ABA. RESULTS: 63 patients (36 women) with RA-associated ILD undergoing ABA therapy were studied. The mean ± standard deviation age at the time of the study was 63...
January 6, 2018: Seminars in Arthritis and Rheumatism
Joseph Jacob, Jin Woo Song, Hee-Young Yoon, Gary Cross, Joseph Barnett, Wen Ling Woo, Fern Adams, Maria Kokosi, Anand Devaraj, Elisabetta Renzoni, Toby M Maher, Dong Soon Kim, Athol U Wells
AIMS: Autoimmune conditions such as rheumatoid arthritis-related interstitial lung disease (RA-ILD) have been linked to the existence of emphysema in never-smokers. We aimed to quantify emphysema prevalence in RA-ILD never-smokers and investigate whether combined pulmonary fibrosis and emphysema (CPFE) results in a worsened prognosis independent of baseline disease extent. METHODS: RA-ILD patients presenting to the Royal Brompton Hospital (n=90) and Asan Medical Center (n=155) had CT's evaluated for a definite usual interstitial pneumonia (UIP) pattern, and visual extents of emphysema and ILD...
January 31, 2018: EBioMedicine
Hanna M Nurmi, Hannu-Pekka Kettunen, Sanna-Katja Suoranta, Minna K Purokivi, Miia S Kärkkäinen, Tuomas A Selander, Riitta L Kaarteenaho
OBJECTIVE: To compare the presence and extent of several high-resolution computed tomography (HRCT) observations in different subtypes of rheumatoid arthritis-related interstitial lung disease (RA-ILD) and to examine associations between radiological findings, hospitalization, age, RA duration, pulmonary function tests (PFT) and survival. MATERIALS AND METHODS: HRCTs from 60 RA-ILD patients were independently evaluated and re-categorized into usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), organizing pneumonia (OP), diffuse alveolar damage (DAD) and unclassified subtypes by two radiologists...
January 2018: Respiratory Medicine
A Heraudeau, C Ricordel, A Sale, M Lederlin, M Kerjouan, B De Latour, F Llamas-Guttierez, B Desrues, S Jouneau
INTRODUCTION: Pancreatic cancer is often not diagnosed until at a metastatic stage at which point the prognosis is very poor. Pulmonary metastases are pleomorphic, often present at the time of diagnosis and can lead to the discovery of an asymptomatic primary disease. CASE REPORT: We describe two cases aged 60 and 74 years, where imaging identified what was thought to be an interstitial lung disease but which was actually metastasis from pancreatic cancer. In the first case, CT showed multiple excavated pulmonary nodules but the presentation with medullary compression led rapidly to pathological diagnosis on bone lesions...
February 1, 2018: Revue des Maladies Respiratoires
B R Sakr, M M Elfishawi, M H ElArousy, A K Hatw, A N AbdulKarim, A B Tammam, A N Kotp, M E Hamed, I E Genedy, E D El Desouky, Z O Nawito
OBJECTIVE: Demonstration of rheumatoid arthritis (RA) characteristics in a large cohort of Egyptian patients. METHODS: Retrospective analysis of data of 3219 RA patients attending the Rheumatology outpatient clinic, Kasr Alainy Hospital, Cairo University; from January 1995 till December 2015. RESULTS: Mean age at disease onset was 36.1 ±13.4 years; 2774 (84%) were females and mean disease duration was 12.9 ±7.9 years. Regarding number of joint affected at disease onset; polyarticular pattern was found in 77...
January 16, 2018: Immunological Investigations
Richard D Bell, Christopher Rudmann, Ronald W Wood, Edward M Schwarz, Homaira Rahimi
INTRODUCTION: Rheumatoid arthritis associated interstitial lung disease (RA-ILD) is a debilitating condition with poor survival prognosis. High resolution computed tomography (CT) is a common clinical tool to diagnose RA-ILD, and is increasingly being adopted in pre-clinical studies. However, murine models recapitulating RA-ILD are lacking, and CT outcomes for inflammatory lung disease have yet to be formally validated. To address this, we validate μCT outcomes for ILD in the tumor necrosis factor transgenic (TNF-Tg) mouse model of RA...
2018: PloS One
Hayley Barnes, Anne E Holland, Glen P Westall, Nicole Sl Goh, Ian N Glaspole
BACKGROUND: Approximately one-third of individuals with interstitial lung disease (ILD) have associated connective tissue disease (CTD). The connective tissue disorders most commonly associated with ILD include scleroderma/systemic sclerosis (SSc), rheumatoid arthritis, polymyositis/dermatomyositis, and Sjögren's syndrome. Although many people with CTD-ILD do not develop progressive lung disease, a significant proportion do progress, leading to reduced physical function, decreased quality of life, and death...
January 3, 2018: Cochrane Database of Systematic Reviews
Katerina D Samara, Athina Trachalaki, Eliza Tsitoura, Anastasios V Koutsopoulos, Eleni D Lagoudaki, Ismini Lasithiotaki, George Margaritopoulos, Panagiotis Pantelidis, Eleni Bibaki, Nikolaos M Siafakas, Nikolaos Tzanakis, Athol U Wells, Katerina M Antoniou
BACKGROUND: Increased protein citrullination and peptidylarginine deiminases (PADIs), which catalyze the citrullination process, are central in Rheumatoid arthritis pathogenesis and probably involved in the initial steps towards autoimmunity. Approximately, 10% of RA patients develop clinically significantly ILD. A possible shared role of protein citrullination in rheumatoid arthritis associated interstitial lung disease (RA-ILD), and idiopathic pulmonary fibrosis (IPF) pathogenesis remains unclear...
December 29, 2017: Respiratory Research
Rahil Giti, Massood Hosseinzadeh
Flexible fiberoptic bronchoscopy is often the initial technique for diagnosis of lung and bronchial tumors. Many studies have shown the high accuracy rate of bronchial washing and brushing cytology in the evaluation of neoplastic and non-neoplastic bronchopulmonary lesions. The aim of this study is to emphasize the value of the bronchial cytologic findings for diagnosis of non-neoplastic bronchopulmonary lesions. In a cross-sectional study, we retrieved all cases with bronchial washing and brushing cytology from 21 Mach 2014 to 21 December 2015...
October 2017: Acta Medica Iranica
Alexandra Balbir-Gurman, Ludmila Guralnik, Mordechai Yigla, Yolanda Braun-Moscovici, Emilia Hardak
OBJECTIVE: Interstitial lung disease (ILD) is a frequent and severe complication of rheumatoid arthritis (RA), resulting in pulmonary fibrosis (PF) and respiratory failure. METHODS: Chest computed tomography (CT-c) or high resolution CT (HRCT) is the main modality for assessment of ILD. We performed a systematic literature review on CT-c/HRCT findings in patients with ILD-RA, using the MEDLINE database for the period from 1991 to 2015. RESULTS: Findings on CT-c/HRCT attributed to ILD-RA are variable (ground glass opacities, reticular and nodular pattern, as well as a combined pattern of emphysema and PF)...
February 2018: Autoimmunity Reviews
Wei Deng, Chaoyang Miao, Xiaoyan Zhang
We report a case of a 30-year-old Chinese woman with rheumatoid arthritis and interstitial lung disease who abruptly developed generalized pustules and a high fever for 10 days. She had been taking oral prednisone, iguratimod and total glucosides of peony regularly for 5 months prior. In addition, she had taken metronidazole for 3 days 20 days prior which she had used before with no adverse reaction. She had no history of similar lesions and psoriasis. A biopsy of a pustule on the back showed spongiform pustule of Kogoj...
November 23, 2017: Journal of Dermatology
Omer S B Alamoudi, Suzan Mansour Attar
BACKGROUND AND OBJECTIVES: Pleuropulmonary (PP) involvement in rheumatoid arthritis (RA) is associated with high morbidity and mortality. Nevertheless, limited data are available regarding lung complications in the Middle East, especially in Saudi Arabia. The objectives of the current study were to determine the prevalence of PP manifestations and to identify the associated risk factors. METHODS: This was a retrospective study involving 419 patients diagnosed at a tertiary center over a 12...
October 2017: Annals of Thoracic Medicine
Francisco Paulin, Alejandra Babini, Marta Mamani, Juan Mercado, Fabián Caro
The prevalence of interstitial lung disease in patients with rheumatoid arthritis varies from 10 to 42%. Rheumatoid arthritis patients with interstitial lung disease have three times the risk of death compared with those without the disease. Prognosis seems to be related to the high-resolution computed tomography pattern. Usual interstitial pneumonia pattern, resembling idiopathic pulmonary fibrosis, carries a worse prognosis. Validated strategies to identify different phenotypes and assess the disease activity in rheumatoid arthritis interstitial lung disease are lacking...
September 2017: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
Jing Shi, Erika Darrah, Gary P Sims, Tomas Mustelin, Kevon Sampson, Maximilian F Konig, Clifton O Bingham, Antony Rosen, Felipe Andrade
OBJECTIVES: The citrullinating enzyme peptidylarginine deiminase type 4 (PAD4) is the target of a polyclonal group of autoantibodies in patients with rheumatoid arthritis (RA). A subgroup of such antibodies, initially identified by cross-reactivity with peptidylarginine deiminase type 3 (PAD3), is strongly associated with progression of radiographic joint damage and interstitial lung disease and has the unique ability to activate PAD4. The features of these antibodies in terms of their T cell-dependent origin, genetic characteristics and effect of individual antibody specificities on PAD4 function remain to be defined...
January 2018: Annals of the Rheumatic Diseases
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