Rheumatoid arthritis-associated interstitial lung disease

Joshua J Solomon, Kevin K BrownAutoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USAAbstract: Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting 1% of the US population. Patients can have extra-articular manifestations of their dis...

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Autores principales:	Brown KK, Solomon JJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/80a3d4d050984aaab7adcb8a2b00d989
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spelling	oai:doaj.org-article:80a3d4d050984aaab7adcb8a2b00d9892021-12-02T01:52:45ZRheumatoid arthritis-associated interstitial lung disease1179-156Xhttps://doaj.org/article/80a3d4d050984aaab7adcb8a2b00d9892012-03-01T00:00:00Zhttp://www.dovepress.com/rheumatoid-arthritis-associated-interstitial-lung-disease-a9428https://doaj.org/toc/1179-156XJoshua J Solomon, Kevin K BrownAutoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USAAbstract: Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting 1% of the US population. Patients can have extra-articular manifestations of their disease and the lungs are commonly involved. RA can affect any compartment of the respiratory system and high resolution computed tomography (HRCT) of the lung is abnormal in over half of these patients. Interstitial lung disease is a dreaded complication of RA. It is more prevalent in smokers, males, and those with high antibody titers. The pathogenesis is unknown but data suggest an environmental insult in the setting of a genetic predisposition. Smoking may play a role in the pathogenesis of disease through citrullination of protein in the lung leading to the development of autoimmunity. Patients usually present in middle age with cough and dyspnea. Pulmonary function testing most commonly shows reduced diffusion capacity for carbon monoxide and HRCT reveals a combination of reticulation and ground glass abnormalities. The most common pattern on HRCT and histopathology is usual interstitial pneumonia (UIP), with nonspecific interstitial pneumonia seen less frequently. There are no large-scale well-controlled treatment trials. In severe or progressive cases, treatment usually consists of corticosteroids with or without a cytotoxic agent for 6 months or longer. RA interstitial lung disease is progressive; over half of patients show radiographic progression within 2 years. Patients with a UIP pattern on biopsy have a survival similar to idiopathic pulmonary fibrosis.Keywords: rheumatoid arthritis, interstitial lung disease, nonspecific interstitial pneumonia, usual interstitial pneumonia, anti-CCPBrown KKSolomon JJDove Medical PressarticleDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol 2012, Iss default, Pp 21-31 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 Brown KK Solomon JJ Rheumatoid arthritis-associated interstitial lung disease
description	Joshua J Solomon, Kevin K BrownAutoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USAAbstract: Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting 1% of the US population. Patients can have extra-articular manifestations of their disease and the lungs are commonly involved. RA can affect any compartment of the respiratory system and high resolution computed tomography (HRCT) of the lung is abnormal in over half of these patients. Interstitial lung disease is a dreaded complication of RA. It is more prevalent in smokers, males, and those with high antibody titers. The pathogenesis is unknown but data suggest an environmental insult in the setting of a genetic predisposition. Smoking may play a role in the pathogenesis of disease through citrullination of protein in the lung leading to the development of autoimmunity. Patients usually present in middle age with cough and dyspnea. Pulmonary function testing most commonly shows reduced diffusion capacity for carbon monoxide and HRCT reveals a combination of reticulation and ground glass abnormalities. The most common pattern on HRCT and histopathology is usual interstitial pneumonia (UIP), with nonspecific interstitial pneumonia seen less frequently. There are no large-scale well-controlled treatment trials. In severe or progressive cases, treatment usually consists of corticosteroids with or without a cytotoxic agent for 6 months or longer. RA interstitial lung disease is progressive; over half of patients show radiographic progression within 2 years. Patients with a UIP pattern on biopsy have a survival similar to idiopathic pulmonary fibrosis.Keywords: rheumatoid arthritis, interstitial lung disease, nonspecific interstitial pneumonia, usual interstitial pneumonia, anti-CCP
format	article
author	Brown KK Solomon JJ
author_facet	Brown KK Solomon JJ
author_sort	Brown KK
title	Rheumatoid arthritis-associated interstitial lung disease
title_short	Rheumatoid arthritis-associated interstitial lung disease
title_full	Rheumatoid arthritis-associated interstitial lung disease
title_fullStr	Rheumatoid arthritis-associated interstitial lung disease
title_full_unstemmed	Rheumatoid arthritis-associated interstitial lung disease
title_sort	rheumatoid arthritis-associated interstitial lung disease
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/80a3d4d050984aaab7adcb8a2b00d989
work_keys_str_mv	AT brownkk rheumatoidarthritisassociatedinterstitiallungdisease AT solomonjj rheumatoidarthritisassociatedinterstitiallungdisease
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Rheumatoid arthritis-associated interstitial lung disease

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