Lung involvement in patients with rheumatoid arthritis: a cross-sectional study-Reference-Cited by-同舟云学术

Lung involvement in patients with rheumatoid arthritis: a cross-sectional study

Published:2023-12-01 Issue: Volume: Page:
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de Souza Silvana Magalhães Passos¹^ORCID,Alves Tatiana Senna Galvão Nonato¹,Silva Ana Flávia¹,de Oliveira Isabela Silva¹,Laporte Larrie²^ORCID,Nogueira Carla¹,Ferreira Lucas Guimarães Andrade¹,Santiago Mittermayer³

Affiliation:

1. UFBA: Universidade Federal da Bahia

2. Bahiana School of Medicine and Public Health: Escola Bahiana de Medicina e Saude Publica

3. EBMSP: Escola Bahiana de Medicina e Saude Publica

Abstract

Abstract Background Rheumatoid arthritis (RA) is a chronic inflammatory condition primarily characterized by joint pain and swelling. However, it can also affect various organs, including the heart, nervous system, eyes, and lungs. Pulmonary involvement is a significant contributor to morbidity and mortality in RA patients, encompassing a spectrum of manifestations such as interstitial lung disease (ILD), bronchiectasis, pleural involvement, and more. ILD can progress to pulmonary fibrosis, impacting the overall prognosis of RA. Methods It is a prospective, analytical, and descriptive cross-sectional study conducted between September 2019 and September 2022 involving RA patients diagnosed according to the 2010 classification criteria of the American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR). Structured interviews collected demographic and clinical data, while laboratory tests, HRCT scans, and pulmonary function tests were performed. Disease activity was assessed using DAS-28 and SDAI. Results A total of 203 patients were included, predominantly female (88%), with a mean age of 57.14 years. Most patients were non-smokers (74.9%) and exhibited moderate disease activity (35% by DAS-28, 41.1% by SDAI). Nearly half of the sample had antibodies, with 47.5% positive for RF and 48.5% for Anti-CCP. HRCT revealed abnormalities in 89.6% of patients, with ILD present in 17% and pulmonary fibrosis in 6.5%. RF was associated with ILD and small airway involvement, while male gender correlated with emphysema and small airway involvement. Conclusions Pulmonary involvement, assessed via HRCT, was highly prevalent in RA patients, even those without respiratory symptoms. These findings underscore the importance of early pulmonary evaluation during RA, as well as the need for monitoring and managing pulmonary manifestations, particularly in patients with specific risk factors such as male gender, advanced age, and positive antibodies.

Publisher

Research Square Platform LLC

Reference44 articles.

1. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet [Internet]. 2016 Oct 22 [cited 2023 Nov 12];388(10055):2023–38. Available from: https://pubmed.ncbi.nlm.nih.gov/27156434/.

2. Shaw M, Collins BF, Ho LA, Raghu G. Rheumatoid arthritis-associated lung disease. Eur Respir Rev [Internet]. 2015 [cited 2023 Nov 12];24(135):1–16. Available from: https://pubmed.ncbi.nlm.nih.gov/25726549/.

3. Esposito AJ, Chu SG, Madan R, Doyle TJ, Dellaripa PF. Thoracic Manifestations of Rheumatoid Arthritis. Clin Chest Med [Internet]. 2019 Sep 1 [cited 2023 Nov 12];40(3):545. Available from: /pmc/articles/PMC6994971/.

4. Solomon JJ, Chung JH, Cosgrove GP, Demoruelle MK, Fernandez-Perez ER, Fischer A et al. Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease. Eur Respir J [Internet]. 2016 Feb 1 [cited 2023 Nov 12];47(2):588–96. Available from: https://pubmed.ncbi.nlm.nih.gov/26585429/.

5. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum [Internet]. 2010 [cited 2023 Nov 12];62(9):2569–81. Available from: https://pubmed.ncbi.nlm.nih.gov/20872595/.