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ILD on rheumatoid arthritis

Shomi Oka, Hiroshi Furukawa, Kota Shimada, Atsushi Hashimoto, Akiko Komiya, Naoshi Fukui, Naoyuki Tsuchiya, Shigeto Tohma
BACKGROUND: Interstitial lung disease (ILD) is frequently associated with rheumatoid arthritis (RA), and is designated RA-associated ILD (RA-ILD). RA-ILD has a large impact on the prognosis of RA. Here, we investigated the micro RNAs (miRNAs) profiles to determine whether they may be useful for diagnosing RA-ILD. METHODS: RNA was isolated from plasma samples and cDNA was synthesized. Real-time RT-PCR analysis was performed to evaluate 752 miRNA expression profiles in plasma pools from RA patients with or without RA-ILD...
January 19, 2017: BMC Musculoskeletal Disorders
Andrea Picchianti Diamanti, Milica Markovic, Giuseppe Argento, Simonetta Giovagnoli, Alberto Ricci, Bruno Laganà, Raffaele D'Amelio
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that can present different extrarticular manifestations involving heart, lungs and kidneys. In recent years there has been a growing awareness of the central role played by the lungs in the onset and progression of RA. In particular interstitial lung disease (ILD) is a common pulmonary manifestation that may be related to the inflammatory process itself, infectious complications and to the treatments used. Management of patients with ILD/RA is still a challenge for clinicians, both synthetic [mainly methotrexate (MTX), leflunomide] and biologic immunosuppressors [mainly anti-tumor necrosis factor (TNF)α] have in fact been related to the onset or worsening of lung diseases with conflicting data...
January 2017: Therapeutic Advances in Respiratory Disease
Elana J Bernstein, R Graham Barr, John H M Austin, Steven M Kawut, Ganesh Raghu, Jessica L Sell, Eric A Hoffman, John D Newell, Jubal R Watts, P Hrudaya Nath, Sushil K Sonavane, Joan M Bathon, Darcy S Majka, David J Lederer
BACKGROUND: Adults with interstitial lung disease (ILD) often have serologic evidence of autoimmunity of uncertain significance without overt autoimmune disease. We examined associations of rheumatoid arthritis (RA)-associated antibodies with subclinical ILD in community-dwelling adults. METHODS: We measured serum rheumatoid factor (RF) and anticyclic citrullinated peptide antibody (anti-CCP) and high attenuation areas (HAAs; CT attenuation values between -600 and -250 Hounsfield units) on cardiac CT in 6736 community-dwelling US adults enrolled in the Multi-Ethnic Study of Atherosclerosis...
September 8, 2016: Thorax
M Kristen Demoruelle, Shikha Mittoo, Joshua J Solomon
Interstitial lung disease (ILD) is commonly present in patients with an underlying connective tissue disease (CTD), particularly those with systemic sclerosis, rheumatoid arthritis, and inflammatory myositis. The clinical spectrum can range from asymptomatic findings on imaging to respiratory failure and death. Distinguishing features in the clinical, radiographic, and histopathologic characteristics of CTD-ILD subsets can predict prognosis and treatment response. Treatment often consists of combinations of immunosuppressive medications, but there is a paucity of guidance in the literature to help clinicians determine appropriate screening and management of CTD-ILD...
February 2016: Best Practice & Research. Clinical Rheumatology
Li-Ta Keng, Mong-Wei Lin, Hsien-Neng Huang, Kuei-Pin Chung
Patients with rheumatoid arthritis (RA) often have pulmonary involvement, and interstitial lung disease (ILD) is the primary manifestation, in which diffuse alveolar damage (DAD) is a rare histopathologic pattern. Leflunomide (LEF) is a frequently prescribed disease-modifying antirheumatic drug for treating RA. LEF-related ILD in the form of DAD has been reported in patients with RA, with the duration of LEF treatment before symptom onset ranging from 6 to 1204 days.We present a case of elderly woman with RA under prolonged LEF treatment for >9 years (3291 days), who had acute respiratory failure with the initial presentation of exertional dyspnea, fever, chills, and productive cough for 2 days...
June 2016: Medicine (Baltimore)
Koichi Waseda, Kazuki Ocho, Kou Hasegawa, Kosuke Kimura, Masaya Iwamuro, Yoshihisa Hanayama, Eisei Kondo, Nobuaki Miyahara, Fumio Otsuka
KL-6 is a glycoprotein found predominantly on type II pneumocytes and alveolar macrophages, and often shows increased serum levels in patients with interstitial pneumonia. We report a case of mycobacterium avium complex (MAC) infection whose disease activity was correlated with KL-6 levels in serum. During treatment of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) with prednisolone, chest image findings improved in association with decreased KL-6 levels. Following tapering of prednisolone, chest image findings deteriorated again as levels of KL-6 increased, suggesting recurrence of RA-ILD...
June 2016: Acta Medica Okayama
Takafumi Suda
Pulmonary involvement is common in rheumatoid arthritis (RA) and affects all the components of the lung. Interstitial lung disease (ILD) is the most predominant pulmonary manifestation and has been identified as the main cause of morbidity and mortality in RA. Clinically significant RA-ILD occurs in approximately 10% of RA patients. Several risk factors, such as old age, male gender, and smoking, have been reported to date. Histologically, the proportion of the usual interstitial pneumonia (UIP) pattern is higher in RA-ILD than in ILD associated with other connective tissue diseases, and RA-ILD also shows nonspecific interstitial pneumonia and organizing pneumonia patterns...
2015: Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
Irene Jarana Aparicio, Joyce S Lee
Interstitial lung disease (ILD) complicating connective tissue disorders, such as scleroderma and rheumatoid arthritis, is associated with significant morbidity and mortality. Progress has been made in our understanding of these collective diseases; however, there are still many unanswered questions. In this review, we describe the current views on epidemiology, clinical presentation, treatment, and prognosis in patients with connective tissue disease (CTD)-associated ILD. We also highlight several areas that remain unresolved and in need of further investigation, including interstitial pneumonia with autoimmune features, histopathologic phenotype, and pharmacologic management...
June 2016: Seminars in Respiratory and Critical Care Medicine
Mineto Ota, Yukiko Iwasaki, Hiroaki Harada, Oh Sasaki, Yasuo Nagafuchi, Shinichiro Nakachi, Shuji Sumitomo, Hirofumi Shoda, Shigeto Tohma, Keishi Fujio, Kazuhiko Yamamoto
OBJECTIVES: Acute or subacute exacerbations are recognized as a severe complication of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Nevertheless, the role of intensive immunosuppression in RA-ILD remains elusive. We attempted to evaluate the clinical characteristics and efficacy of immunosuppressive treatment in exacerbated RA-ILD. METHODS: Clinical data, including respiratory function, imaging, treatment, and prognosis, were retrospectively collected for 17 patients with RA-ILD who required hospitalization at the University of Tokyo Hospital due to an acute exacerbation (12 patients) or subacute exacerbation (5 patients)...
January 2017: Modern Rheumatology
Kota Takahashi, Hiroyuki Taniguchi, Masahiko Ando, Koji Sakamoto, Yasuhiro Kondoh, Naohiro Watanabe, Tomoki Kimura, Kensuke Kataoka, Atsushi Suzuki, Satoru Ito, Yoshinori Hasegawa
BACKGROUND: Pulmonary hypertension (PH) can develop in connective tissue disease associated interstitial lung disease (CTD-ILD), and contributes to increased morbidity and mortality. However, except for systemic sclerosis and mixed connective tissue disease, the impact of mean pulmonary arterial pressure (MPAP) on survival in CTD-ILD has not been sufficiently elucidated. We hypothesized that pulmonary arterial pressure may be a prognostic factor in CTD-ILDs regardless of the kind of CTD...
April 19, 2016: BMC Pulmonary Medicine
Mitsuhiro Akiyama, Yuko Kaneko, Kunihiro Yamaoka, Harumi Kondo, Tsutomu Takeuchi
The objective of the study was to identify risk factors for acute exacerbation of interstitial lung disease (ILD) during tocilizumab treatment in patients with rheumatoid arthritis (RA). This is a retrospective, case-control study. We reviewed 395 consecutive RA patients who received tocilizumab. First, we divided the patients according to the presence (RA-ILD) or absence of ILD (non-ILD) assessed by chest X-ray or high-resolution computed tomography, and compared them for characteristics relevant to RA-ILD...
June 2016: Rheumatology International
Cheilonda Johnson, Jon T Giles, Joan Bathon, David Lederer, Eric A Hoffman, R Graham Barr, Sonye K Danoff
A population-based cohort showed an association between cigarette smoking and subclinical parenchymal lung disease defined as regions of increased computed tomography (CT) lung densitometry. This technique has not been applied to the rheumatoid arthritis (RA) population where associated ILD is highly prevalent. The association between cumulative cigarette smoking and volume of areas of high attenuation (HAA: >-600 and <-250 Hounsfield Units) on full inspiratory CT was compared in 172 RA participants and 3,969 controls in a general population sample...
2016: PloS One
Beth Wallace, Dharshan Vummidi, Dinesh Khanna
PURPOSE OF REVIEW: Interstitial lung disease (ILD), though a common and often a severe manifestation of many connective tissue diseases (CTD), is challenging to manage because of its variable presentation and the relative lack of guidelines to assist the clinician. In this review, we discuss the approach to diagnosis, treatment, and monitoring patients with CTD-associated ILD, with a focus on systemic sclerosis (SSc), rheumatoid arthritis (RA), and idiopathic inflammatory myopathy (IIM)...
May 2016: Current Opinion in Rheumatology
Thomas Bahmer, Micaela Romagnoli, Francesco Girelli, Martin Claussen, Klaus F Rabe
Interstitial lung diseases (ILD), also defined as diffuse parenchymal lung diseases (DPLD) include a heterogeneous group of pulmonary disorders. They may be caused by an underlying connective tissue disease (CTD), Rheumatoid Arthritis (RA) or ANCA-associated Vasculitis (AAV). Pulmonary manifestations of these conditions may also precede systemic onset and therefore, pulmonologists may be confronted with diagnosing a systemic rheumatic disease. For the discrimination of CTD-related ILD and idiopathic interstitial pneumonia (IIP), serological testing is recommended...
April 2016: Respiratory Medicine
Stephen C Mathai, Sonye K Danoff
The lung is a common site of complications of systemic connective tissue disease (CTD), and lung involvement can present in several ways. Interstitial lung disease (ILD) and pulmonary hypertension are the most common lung manifestations in CTD. Although it is generally thought that interstitial lung disease develops later on in CTD it is often the initial presentation ("lung dominant" CTD). ILD can be present in most types of CTD, including rheumatoid arthritis, scleroderma, systemic lupus erythematosus, polymyositis or dermatomyositis, Sjögren's syndrome, and mixed connective tissue disease...
February 24, 2016: BMJ: British Medical Journal
Liu-nan Song, Xiao-dan Kong, Hong-jiang Wang, Li-bin Zhan
INTRODUCTION: Development of an animal model of rheumatoid arthritis-interstitial lung disease (RA-ILD) and improved knowledge of the pathogenesis of RA-ILD may facilitate earlier diagnosis and the development of more effective targeted therapies. METHODS: Adult male Wistar rats were studied in an adjuvant arthritis (AA) model induced by the injection of Freund's complete adjuvant (FCA). Rats were sacrificed on days 7, 14, 21, and 28 after FCA injection. Lung tissue was obtained for histopathological examination and evaluation of Caveolin-1 (Cav-1) and transforming growth factor-β (TGF-β1) protein expression levels...
2016: BioMed Research International
Sandra Chartrand, Jeffrey J Swigris, Lina Peykova, Aryeh Fischer
OBJECTIVE: To describe our experience with rituximab (RTX) as treatment for a diverse spectrum of chronic connective tissue disease-associated interstitial lung disease (CTD-ILD). METHODS: Twenty-four subjects with CTD-ILD were included. All had pulmonary function testing before and after their first RTX infusion. Each subject was evaluated in a multidisciplinary autoimmune and ILD outpatient clinic. Data were extracted by retrospective review of complete medical records...
January 15, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Lorenzo Cavagna, Laura Nuño, Carlo Alberto Scirè, Marcello Govoni, Francisco Javier Lopez Longo, Franco Franceschini, Rossella Neri, Santos Castañeda, Walter Alberto Sifuentes Giraldo, Roberto Caporali, Florenzo Iannone, Enrico Fusaro, Giuseppe Paolazzi, Raffaele Pellerito, Andreas Schwarting, Lesley Ann Saketkoo, Norberto Ortego-Centeno, Luca Quartuccio, Elena Bartoloni, Christof Specker, Trinitario Pina Murcia, Renato La Corte, Federica Furini, Valentina Foschi, Javier Bachiller Corral, Paolo Airò, Ilaria Cavazzana, Julia Martínez-Barrio, Michelle Hinojosa, Margherita Giannini, Simone Barsotti, Julia Menke, Kostantinos Triantafyllias, Rosetta Vitetta, Alessandra Russo, Laura Bogliolo, Gianluigi Bajocchi, Elena Bravi, Giovanni Barausse, Roberto Bortolotti, Carlo Selmi, Simone Parisi, Fausto Salaffi, Carlomaurizio Montecucco, Miguel Angel González-Gay
Anti-Jo-1 is the most frequently detectable antibody in the antisynthetase syndrome (ASSD), an autoimmune disease characterized by the occurrence of arthritis, myositis, and interstitial lung disease (ILD). Recently, we organized an international collaborative group called American and European NEtwork of Antisynthetase Syndrome (AENEAS) for the study of this rare and fascinating disease. The group collected and published one of the largest series of ASSD patients ever described and with one of the longer follow-up ever reported...
February 2017: Clinical Reviews in Allergy & Immunology
Ekin Oktay Oguz, Orhan Kucuksahin, Murat Turgay, Mustafa Turgut Yildizgoren, Askin Ates, Nalan Demir, Ozlem Ozdemir Kumbasar, Gulay Kinikli, Nursen Duzgun
It was aimed to evaluate KL-6 glycoprotein levels to determine if it may be a diagnostic marker for the connective tissue diseases (CTDs) predicting CTD-related interstitial lung diseases (ILDs) (CTD-ILD) development and to examine if there was a difference between patients and healthy controls. The study included 113 patients with CTD (45 CTD without lung involvement, 68 CTD-ILD) and 45 healthy control subjects. KL-6 glycoprotein levels were analyzed with ELISA in patients and the control group. The relationship between KL-6 glycoprotein levels and CTD-ILD was assessed...
March 2016: Clinical Rheumatology
Joshua J Solomon, Jonathan H Chung, Gregory P Cosgrove, M Kristen Demoruelle, Evans R Fernandez-Perez, Aryeh Fischer, Stephen K Frankel, Stephen B Hobbs, Tristan J Huie, Jill Ketzer, Amar Mannina, Amy L Olson, Gloria Russell, Yutaka Tsuchiya, Zulma X Yunt, Pearlanne T Zelarney, Kevin K Brown, Jeffrey J Swigris
Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis. There is lack of clarity around predictors of mortality and disease behaviour over time in these patients.We identified rheumatoid arthritis-related interstitial lung disease (RA-ILD) patients evaluated at National Jewish Health (Denver, CO, USA) from 1995 to 2013 whose baseline high-resolution computed tomography (HRCT) scans showed either a nonspecific interstitial pneumonia (NSIP) or a "definite" or "possible" usual interstitial pneumonia (UIP) pattern...
February 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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