Document Detail


Histopathologic pattern and clinical features of rheumatoid arthritis-associated interstitial lung disease.
MedLine Citation:
PMID:  15947315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVES: To investigate the histopathologic pattern and clinical features of patients with rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) according to the American Thoracic Society (ATS)/European Respiratory Society consensus classification of idiopathic interstitial pneumonia. DESIGN: Retrospective review. SETTING: Two thousand-bed, university-affiliated, tertiary referral center. PATIENTS: Eighteen patients with RA who underwent surgical lung biopsy (SLBx) for suspected ILD. METHOD: SLBx specimens were reviewed and reclassified by three lung pathologists according to the ATS/European Respiratory Society classification. Clinical features and follow-up courses for the usual interstitial pneumonia (UIP) pattern and the nonspecific interstitial pneumonia (NSIP) pattern were compared. RESULTS: The histopathologic patterns were diverse: 10 patients with the UIP pattern, 6 patients with the NSIP pattern, and 2 patients with inflammatory airway disease with the organizing pneumonia pattern. RA preceded ILD in the majority of patients (n = 12). In three patients, ILD preceded RA; in three patients, both conditions were diagnosed simultaneously. The majority (n = 13) of patients had a restrictive defect with or without low diffusion capacity of the lung for carbon monoxide (D(LCO)) on pulmonary function testing; 2 patients had only low (D(LCO)). The UIP and NSIP groups were significantly different in their male/female ratios (8/2 vs 0/6, respectively; p = 0.007) and smoking history (current/former or nonsmokers, 8/2 vs 0/6; p = 0.007). Many of the patients with the UIP pattern had typical high-resolution CT features of UIP. Five patients with the UIP pattern died, whereas no deaths occurred among patients with the NSIP pattern during median follow-up durations of 4.2 years and 3.7 years, respectively. CONCLUSIONS: The histopathologic type of RA-ILD was diverse; in our study population, the UIP pattern seemed to be more prevalent than the NSIP pattern.
Authors:
Hyun-Kyung Lee; Dong Soon Kim; Bin Yoo; Joon Beom Seo; Jae-Yoon Rho; Thomas V Colby; Masanori Kitaichi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Chest     Volume:  127     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-10     Completed Date:  2005-07-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2019-27     Citation Subset:  AIM; IM    
Affiliation:
Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan, College of Medicine, 388-1, Poongnap-dong, Songpa-ku, Seoul, Korea 138-73.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arthritis, Rheumatoid / complications*,  pathology*
Biopsy, Needle
Bronchoalveolar Lavage
Cohort Studies
Female
Humans
Immunohistochemistry
Lung Diseases, Interstitial / complications*,  pathology*
Male
Middle Aged
Probability
Respiratory Function Tests
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index
Statistics, Nonparametric
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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