Acute lung involvement in RA is not always ILD
DOI:
https://doi.org/10.15305/ijrci/v7i1/291Abstract
Rheumatoid arthritis is a systemic inflammatory disorder with diverse extra-articular manifestations including vasculitis, lung disease, inflammatory eye disease and subcutaneous nodule formation. Among these manifestations, lung disease has been identified as a primary contributor of morbidity and mortality. The predominance of non-specific interstitial pneumonia pattern has been observed in most forms of connective tissue-associated ILD. Studies have demonstrated that the usual interstitial pneumonia (UIP) pattern is more prevalent among patients with RA-associated ILD. The extra-articular manifestations have been noted in nearly 50% of the patients, and the lung involvement in majority of the cases.8, 9 This study details the occurrence of lung involvement of viral etiology in RA, which could be misdiagnosed as RA-associated ILD.
References
Kim EJ, Collard HR, King TE. Rheumatoid Arthritis-Associated Interstitial Lung Disease: The Relevance of Histopathologic and Radiographic Pattern. CHEST. 2009 Nov 1;136(5):1397–405.
Atzeni F, Boiardi L, Sallì S, Benucci M, Sarzi-Puttini P. Lung involvement and drug-induced lung disease in patients with rheumatoid arthritis. Expert Rev Clin Immunol. 2013 Jul;9(7):649–57.
Gill JR, Sheng Z-M, Ely SF, Guinee DG, Beasley MB, Suh J, et al. Pulmonary Pathologic Findings of Fatal 2009 Pandemic Influenza A/H1N1 Viral Infections. Arch Pathol Lab Med. 2010 Feb;134(2):235.
Bai L, Gu L, Cao B, Zhai X-L, Lu M, Lu Y, et al. Clinical features of pneumonia caused by 2009 influenza A(H1N1) virus in Beijing, China. Chest. 2011 May;139(5):1156–64.
Jani M, Hirani N, Matteson EL, Dixon WG. The safety of biologic therapies in RA-associated interstitial lung disease. Nat Rev Rheumatol. 2014 May;10(5):284–94.
Roubille C, Haraoui B. Interstitial lung diseases induced or exacerbated by DMARDS and biologic agents in rheumatoid arthritis: a systematic literature review. Semin Arthritis Rheum. 2014 Apr;43(5):613–26.
Saravanan V, Kelly C. Drug-related pulmonary problems in patients with rheumatoid arthritis. Rheumatology (Oxford). 2006 Jul 1;45(7):787–9.
Turesson C, O’Fallon WM, Crowson CS, Gabriel SE, Matteson EL. Occurrence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol. 2002 Jan;29(1):62–7.
Bilgici A, Ulusoy H, Kuru O, Celenk C, Unsal M, Danaci M. Pulmonary involvement in rheumatoid arthritis. Rheumatol Int. 2005 Aug;25(6):429–35.
Rello J, Rodríguez A, Ibañez P, Socias L, Cebrian J, Marques A, et al. Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain. Crit Care. 2009;13(5):R148.
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