C Hyldgaard, S Harders, J Blegvad, M Herly, D Masic, B K Sofíudóttir, G Urbonaviciene, F D Andersen, C Isaksen, B Løgstrup, T Ellingsen
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引用次数: 0
Abstract
Objective: Pulmonary disease is a major cause of excess mortality among patients with rheumatoid arthritis (RA). Interstitial lung disease (ILD) is a feared complication, but the benefit of screening is unknown. The aim of this study was to assess the frequency of pulmonary disease, including ILD, in early RA.
Method: Patients with newly diagnosed RA were recruited prospectively at a single centre and underwent systematic pulmonary function tests (PFTs) and computed tomography (CT) scans at inclusion and after two years.
Results: The study included 150 patients (mean age 57 years, 63% female; 59% current or former smokers). Of these, 136 underwent baseline PFTs and 137 CT. Mean forced expiratory volume in one second was 99% predicted and forced vital capacity 106%. Mean diffusing capacity of the lungs for carbon monoxide (DLCO) was 84% predicted. Frequently detected CT abnormalities were pulmonary nodules (42%), bronchiectasis (29%), and emphysema (20%). Two patients had clinically significant ILD and six had mild reticulation suggestive of preclinical ILD. No ILD progression was identified at two-year follow-up. Smoking was associated with DLCO<80% (p=0.004), combined hyperinflation and diffusion impairment (residual volume>120% and DLCO<80%) (p=0.004), and visual emphysema on CT (p<0.001).
Conclusion: Emphysema and bronchiectasis were common, but most patients had mild disease with preserved lung function. Preclinical or clinical ILD was seen in a minority in this early phase of RA. These findings suggest symptom-based screening and primary intervention focusing on smoking cessation rather than screening for ILD at the time of RA diagnosis.
期刊介绍:
Scandinavian Journal of Rheumatology is the official journal of the Scandinavian Society for Rheumatology, a non-profit organization following the statutes of the Scandinavian Society for Rheumatology/Scandinavian Research Foundation. The main objective of the Foundation is to support research and promote information and knowledge about rheumatology and related fields. The annual surplus by running the Journal is awarded to young, talented, researchers within the field of rheumatology.pasting
The Scandinavian Journal of Rheumatology is an international scientific journal covering clinical and experimental aspects of rheumatic diseases. The journal provides essential reading for rheumatologists as well as general practitioners, orthopaedic surgeons, radiologists, pharmacologists, pathologists and other health professionals with an interest in patients with rheumatic diseases.
The journal publishes original articles as well as reviews, editorials, letters and supplements within the various fields of clinical and experimental rheumatology, including;
Epidemiology
Aetiology and pathogenesis
Treatment and prophylaxis
Laboratory aspects including genetics, biochemistry, immunology, immunopathology, microbiology, histopathology, pathophysiology and pharmacology
Radiological aspects including X-ray, ultrasonography, CT, MRI and other forms of imaging.