Assessment of the clinical features of rheumatoid arthritis-related interstitial lung diseases: a retrospective evaluation

A.C. Genc, Z. Ozturk, A.B. Kara, F. Turkoglu Genc, Y. Aydemir, Y. Gunduz, E. Gonullu

Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey. acgenc@sakarya.edu.tr

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• Internal Medicine
• Rheumatology

OBJECTIVE: Rheumatoid Arthritis (RA) stands as the most prevalent form of inflammatory arthritis, affecting approximately 1% of the population. Among individuals diagnosed with RA, a notable proportion, ranging from 10% to 40%, also experience Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD). This coexistence of RA and ILD has been identified as a detrimental factor contributing to increased mortality rates. Furthermore, RA-ILD often exhibits an insidious nature, posing challenges in its timely detection and management. Hence, our objective was to conduct a retrospective analysis of the clinical characteristics observed in patients who underwent evaluation for RA-ILD.

PATIENTS AND METHODS: A total of 87 patients who were evaluated for RA-ILD within one year were included in the study. This study was conducted retrospectively using a cross-sectional and descriptive approach to analyze the demographic and clinical data of the included patients.

RESULTS: Among the 87 patients, eight were diagnosed with RA-ILD, with four being male and four being female. Of the eight patients, two had non-specific interstitial pneumonia, five had usual interstitial pneumonia, and one had nodules consistent with RA. Subpleural fibrosis increased the likelihood of RA-ILD by 6.9 times. In the group with ILD, the residual volume and total capacity were found to be lower compared to the other group. Among the eight patients diagnosed with RA-ILD, five had used methotrexate before the diagnosis.

CONCLUSIONS: In order to mitigate the risk of delayed diagnosis of RA-ILD, which can lead to increased mortality and has a subtle onset, it is recommended that patients with RA who possess certain risk factors undergo regular monitoring. It is advisable for RA patients to undergo annual assessments involving carbon monoxide diffusion capacity and spirometry function tests. In cases, where deemed necessary, more advanced investigations such as high-resolution computed tomography should be conducted.

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