High-resolution CT and pulmonary function tests in rheumatoid arthritis patients with subclinical interstitial lung disease in Kuwait

被引：7

作者：

Affara, Nasr K. ^{[1
]}

Refaat, Alaa M. ^{[1
]}

Elgawish, Mohamed H. ^{[2
]}

Zakaria, Mohammad A. ^{[3
]}

Dashti, Khaledah A. ^{[4
]}

机构：

[1] Zagazig Univ, Fac Med, Chest Dept, Zagazig, Egypt

[2] Zagazig Univ, Fac Med, Phys Med Rheumatol & Rehabil Dept, Zagazig, Egypt

[3] Ain Shams Univ, Fac Med, Phys Med Rheumatol & Rehabil Dept, Cairo, Egypt

[4] Farwaniya Hosp, Minist Hlth, Radiol Dept, Kuwait, Kuwait

来源：

EGYPTIAN RHEUMATOLOGIST | 2016年 / 38卷 / 02期

关键词：

Subclinical interstitial lung disease; Rheumatoid arthritis; Methotrexate; Kuwait;

D O I：

10.1016/j.ejr.2015.06.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Interstitial lung disease (ILD) is a frequent extra-articular manifestation of RA and can cause significant morbidity and mortality. Aim of the work: To characterize and define the frequency of radiological and functional abnormalities capable of identifying "subclinical" RA-ILD with particular concern to the effect of methotrexate (MTX) therapy. Patients and methods: Sixty patients with RA were recruited with no respiratory manifestations. They were classified into two groups: group 1 included 35 patients receiving MTX and group 2 included 25 patients receiving only nonsteroidal anti-inflammatory drugs. Patients were also classified according to chest high resolution CT (HRCT) as RA-ILD or RA-noILD. Pulmonary function test (PFT) abnormalities were also used to further characterize occult respiratory defects. Results: 38.3% of RA patients had subclinical ILD (25% in group 1 and 13.3% in group 2), while 61.7% were RA-no ILD. The percentage of patients with RA-ILD was insignificantly more in group 1 than group 2 (42.9% and 32% respectively). HRCT score revealed minimal to mild involvement in both groups. Long-standing RA with mean articular duration >50 months carries a significant risk for ILD. Other variables as age, gender, smoking, disease activity or rheumatoid factor seropositivity were not significant risk factors for development of RA-ILD. Conclusions: Lung involvement should always be considered in patients with RA particularly those on MTX therapy even in the absence of chest symptoms. A tight control by PFTs, chest radiography and/or HRCT is necessary. Further studies evaluating the potential effect of MTX on progressive ILD with RA are needed. (C) 2015 The Authors. Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Rheumatic Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：77 / 83

页数：7

共 30 条

[1] 2010 Rheumatoid Arthritis Classification Criteria An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative [J].