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A Retrospective Study of the Clinical, Radiological, and Pathological Characteristics of Patients with Interstitial Pneumonia Preceding Rheumatoid Arthritis

OBJECTIVE: Interstitial lung disease (ILD) is the most critical manifestation in patients with rheumatoid arthritis (RA). In some cases, ILD may appear before the RA onset. Some patients with an initial diagnosis of idiopathic interstitial pneumonia (IIPs) develop RA; however, few studies have repor...

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Autores principales: Sato, Midori, Tabata, Erina, Takemura, Tamiko, Okuda, Ryo, Komatsu, Shigeru, Okudela, Koji, Iwasawa, Tae, Ogura, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332980/
https://www.ncbi.nlm.nih.gov/pubmed/36288980
http://dx.doi.org/10.2169/internalmedicine.0052-22
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author Sato, Midori
Tabata, Erina
Takemura, Tamiko
Okuda, Ryo
Komatsu, Shigeru
Okudela, Koji
Iwasawa, Tae
Ogura, Takashi
author_facet Sato, Midori
Tabata, Erina
Takemura, Tamiko
Okuda, Ryo
Komatsu, Shigeru
Okudela, Koji
Iwasawa, Tae
Ogura, Takashi
author_sort Sato, Midori
collection PubMed
description OBJECTIVE: Interstitial lung disease (ILD) is the most critical manifestation in patients with rheumatoid arthritis (RA). In some cases, ILD may appear before the RA onset. Some patients with an initial diagnosis of idiopathic interstitial pneumonia (IIPs) develop RA; however, few studies have reported on its features, and the details remain unknown. In the present study, the clinical, radiological, and pathological features were evaluated in patients with ILD preceding RA. METHODS: The clinical, radiological, and pathological features of patients with ILD preceding RA were retrospectively reviewed using the medical records. PATIENTS: Ten patients with ILD preceding RA out of 883 IIP patients who underwent a surgical lung biopsy at our hospital from 2004 to 2018 were retrospectively examined. RESULTS: The median patient age was 59 (range 50-76) years old, and 7 of the patients were women. The median time from the ILD diagnosis to the RA onset was 50 (range 33-65) months. Regarding the high-resolution computed tomography pattern, the “indeterminate for UIP” pattern was the most popular, and cysts were seen in all cases. Attenuation around the cyst was prominent. Pathological findings showed plasma cell infiltration, bronchus-associated lymphoid tissue (BALT), and bronchiolitis in the lobules. Cellular and destructive bronchiolitis was noticeable in many patients with ILD preceding RA and contributed to the destruction and dilation of the bronchiole. CONCLUSION: In ILD patients with IIP, radiological and pathological findings with increased attenuation around the cysts, prominent inflammatory cell infiltration (especially in plasma cells), an increase in the BALT number, and cellular and destructive bronchiolitis might serve as helpful RA development indicators.
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spelling pubmed-103329802023-07-12 A Retrospective Study of the Clinical, Radiological, and Pathological Characteristics of Patients with Interstitial Pneumonia Preceding Rheumatoid Arthritis Sato, Midori Tabata, Erina Takemura, Tamiko Okuda, Ryo Komatsu, Shigeru Okudela, Koji Iwasawa, Tae Ogura, Takashi Intern Med Original Article OBJECTIVE: Interstitial lung disease (ILD) is the most critical manifestation in patients with rheumatoid arthritis (RA). In some cases, ILD may appear before the RA onset. Some patients with an initial diagnosis of idiopathic interstitial pneumonia (IIPs) develop RA; however, few studies have reported on its features, and the details remain unknown. In the present study, the clinical, radiological, and pathological features were evaluated in patients with ILD preceding RA. METHODS: The clinical, radiological, and pathological features of patients with ILD preceding RA were retrospectively reviewed using the medical records. PATIENTS: Ten patients with ILD preceding RA out of 883 IIP patients who underwent a surgical lung biopsy at our hospital from 2004 to 2018 were retrospectively examined. RESULTS: The median patient age was 59 (range 50-76) years old, and 7 of the patients were women. The median time from the ILD diagnosis to the RA onset was 50 (range 33-65) months. Regarding the high-resolution computed tomography pattern, the “indeterminate for UIP” pattern was the most popular, and cysts were seen in all cases. Attenuation around the cyst was prominent. Pathological findings showed plasma cell infiltration, bronchus-associated lymphoid tissue (BALT), and bronchiolitis in the lobules. Cellular and destructive bronchiolitis was noticeable in many patients with ILD preceding RA and contributed to the destruction and dilation of the bronchiole. CONCLUSION: In ILD patients with IIP, radiological and pathological findings with increased attenuation around the cysts, prominent inflammatory cell infiltration (especially in plasma cells), an increase in the BALT number, and cellular and destructive bronchiolitis might serve as helpful RA development indicators. The Japanese Society of Internal Medicine 2022-10-26 2023-06-15 /pmc/articles/PMC10332980/ /pubmed/36288980 http://dx.doi.org/10.2169/internalmedicine.0052-22 Text en Copyright © 2023 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Sato, Midori
Tabata, Erina
Takemura, Tamiko
Okuda, Ryo
Komatsu, Shigeru
Okudela, Koji
Iwasawa, Tae
Ogura, Takashi
A Retrospective Study of the Clinical, Radiological, and Pathological Characteristics of Patients with Interstitial Pneumonia Preceding Rheumatoid Arthritis
title A Retrospective Study of the Clinical, Radiological, and Pathological Characteristics of Patients with Interstitial Pneumonia Preceding Rheumatoid Arthritis
title_full A Retrospective Study of the Clinical, Radiological, and Pathological Characteristics of Patients with Interstitial Pneumonia Preceding Rheumatoid Arthritis
title_fullStr A Retrospective Study of the Clinical, Radiological, and Pathological Characteristics of Patients with Interstitial Pneumonia Preceding Rheumatoid Arthritis
title_full_unstemmed A Retrospective Study of the Clinical, Radiological, and Pathological Characteristics of Patients with Interstitial Pneumonia Preceding Rheumatoid Arthritis
title_short A Retrospective Study of the Clinical, Radiological, and Pathological Characteristics of Patients with Interstitial Pneumonia Preceding Rheumatoid Arthritis
title_sort retrospective study of the clinical, radiological, and pathological characteristics of patients with interstitial pneumonia preceding rheumatoid arthritis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332980/
https://www.ncbi.nlm.nih.gov/pubmed/36288980
http://dx.doi.org/10.2169/internalmedicine.0052-22
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