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Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 406927, 5 pages
http://dx.doi.org/10.1155/2013/406927
Clinical Study

Asymptomatic Preclinical Rheumatoid Arthritis-Associated Interstitial Lung Disease

1Rheumatology Department of the First Hospital of Xiamen University, Zhen Hai Road No. 55, Xiamen 361003, China
2Pulmonary Department of the First Hospital of Xiamen University, Zhen Hai Road No. 55, Xiamen 361003, China
3Radiology Department of the First Hospital of Xiamen University, Zhen Hai Road No. 55, Xiamen 361003, China
4University of Miami School of Medicine, Miami, FL 33136, USA

Received 2 May 2013; Revised 29 June 2013; Accepted 11 July 2013

Academic Editor: Guixiu Shi

Copyright © 2013 Juan Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Interstitial lung disease (ILD) is a common extra-articular manifestation of rheumatoid arthritis (RA) and a significant cause of morbidity and mortality. The objective of this study was to define high-resolution chest CT (HRCT) and pulmonary function test (PFT) abnormalities capable of identifying asymptomatic, preclinical forms of RA-ILD that may represent precursors to more severe fibrotic lung disease. Methods. We analyzed chest HRCTs in consecutively enrolled RA patients and subsequently classified these individuals as RA-ILD or RA-no ILD based on the presence/absence of ground glass opacification, septal thickening, reticulation, traction bronchiectasis, and/or honeycombing. Coexisting PFT abnormalities (reductions in percent predicted FEV1, FVC, TLC, and/or DLCO) were also used to further characterize occult respiratory defects. Results. 61% (63/103) of RA patients were classified as RA-ILD based on HRCT and PFT abnormalities, while 39% (40/103) were designated as RA-no ILD. 57/63 RA-ILD patients lacked symptoms of significant dyspnea or cough at the time of HRCT and PFT assessment. Compared with RA-no ILD, RA-ILD patients were older and had longer disease duration, higher articular disease activity, and more significant PFT abnormalities. Conclusion. HRCT represents an effective tool to detect occult/asymptomatic ILD that is highly prevalent in our unselected, university-based cohort of RA patients.