CT Pulmonary Manifestations in Patients with Rheumatoid Arthritis: Visual scoring versus pulmonary function

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan Mohamed Eissa ◽  
Ahmed Mohamed Osman ◽  
Nehal Gamal Eldine El sayed
Keyword(s):  
Rheumatoid Arthritis ◽  
Retrospective Study ◽  
Pulmonary Function ◽  
Pulmonary Involvement ◽  
University Hospitals ◽  
Reticular Pattern ◽  
Pulmonary Manifestations ◽  
Chest Examination

Abstract Background Pulmonary involvement is the most common extra-articular manifestation of Rheumatoid arthritis. Aim of the Work To highlight the role of HRCT in detection and characterization of variable pulmonary manifestations that can be encountered in patients with Rheumatoid Arthritis trying to correlate the CT pulmonary manifestations with pulmonary functions using CT scoring system. Patients and Methods This was a retrospective study that included 32 patients who were diagnosed to have Rheumatoid Arthritis either outpatients or referred from the Rheumatology Department at Ain Shams University Hospitals to the Radiodiagnosis Department for HRCT chest examination. An acceptance from the ethical committee of Faculty of Medicine - Ain Shams University was obtained to use the data stored on PACs system with the patient’s consent was waived being a retrospective study. All patients underwent HRCT image analysis regarding the CT features and CT score for disease severity. Also, all patients did spirometery for pulmonary function assessment. Results Analyzing the data showed a female sex predominance (90.6%). 87% of the patients were diagnosed to have RA for more than 2 years duration. The most common respiratory symptom was dyspnea and the restrictive pattern was the commonest PFT finding. Ground glass pattern was the most common 78.1% followed by reticular pattern which was seen in 68.8% of patients. PFT and HRCT showed a positive correlation regarding the severity. Conclusion HRCT is a modality of choice for detection of pulmonary manifestation of rheumatoid arthritis patients with CT scoring can be used to assess the severity of disease and degree of lung involvement which is correlated with pulmonary function test.

scholarly journals Subclinical pulmonary involvement in active IBD responds to biological therapy

2021 ◽  
Author(s):  
M Ellrichmann ◽  
J Bethge ◽  
J Boesenkoetter ◽  
C Conrad ◽  
R Noth ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Pulmonary Involvement ◽  
Forced Expiration ◽  
Extraintestinal Manifestation ◽  
Prospective Longitudinal Study ◽  
Function Tests ◽  
Pulmonary Manifestations ◽  
Prospective Longitudinal ◽  
Active Disease

Abstract Objective Increased mortality from respiratory diseases was observed in epidemiologic studies of patients with ulcerative colitis (UC) as a potentially underestimated extraintestinal manifestation. We therefore investigated the presence of pulmonary manifestations of IBD and the potential effect of TNF-α-inhibitors on pulmonary function tests (PFT) in a prospective, longitudinal study. Design 92 consecutive patients with IBD (49 Crohn´s disease (CD), 43 UC) and 20 healthy controls were recruited. 50 patients with IBD were in remission, 42 had active disease with 22 of these being examined prior and 6 weeks after initiating anti-TNF therapy. Pulmonary function tests (PFT) were evaluated using the Medical Research Council (MRC) dyspnea index and a standardized body plethysmography. IBD activity was assessed using Harvey-Bradshaw index for CD and partial-Mayo-score for UC. Data are presented as mean±SEM. Results Patients with active IBD showed significant reduction of PFT. Forced expiration (Tiffeneau index)-values (FEV1%) were significantly reduced in IBD patients with active disease (78.8±1.1) compared to remission (86.1±0.9; p=0.0002) and to controls (87.3±1.3, p=0.001). Treatment with anti-TNF induced a significant relief in obstruction (p=0.003 for FEV1% in comparison to baseline levels). The level of pulmonary obstruction significantly correlated with clinical inflammation scores (HBI or Mayo). Conclusion Patients with active IBD present with significant obstructive abnormalities in their PFTs. Obstruction is related to inflammatory activity with anti-TNF improving PFTs. Pulmonary obstruction and possibly chronic broncho-pulmonary inflammation is an overlooked problem in active IBD that is probably obscured by intestinal symptoms.

scholarly journals Clinical, Epidemiological, and Histopathological Features of Respiratory Involvement in Rheumatoid Arthritis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Alessia Alunno ◽  
Roberto Gerli ◽  
Roberto Giacomelli ◽  
Francesco Carubbi
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Disease ◽  
Pulmonary Inflammation ◽  
Pulmonary Involvement ◽  
Susceptibility To Infection ◽  
Respiratory Involvement ◽  
Radiological Data ◽  
Pulmonary Manifestations ◽  
Wide Range ◽  
Parenchymal Disease

Although by definition rheumatoid arthritis (RA) is an articular disorder, it is a systemic disease, and 18–40% of patients experience extra-articular manifestations (EAMs). The involvement of the respiratory system occurs in about 30–40% of RA patients, and in about 10–20% of them it represents the first manifestation of RA. A wide range of pulmonary manifestations are detectable in RA patients, including pulmonary parenchymal disease, pleural involvement, and airway and pulmonary inflammation. The clinical, radiological, and histological spectra of respiratory manifestations in RA reflect chronic immune activation, increased susceptibility to infection (often related to immunosuppressive medications), or direct drug. The type and severity of pulmonary involvement influence the prognosis, ranging from mild self-limiting conditions to severe life-threatening complications. Herein, we reviewed the various manifestations of respiratory involvement in RA, providing an overview on epidemiological, histological, clinical, and radiological data.

Radiological patterns of pulmonary involvement may predict treatment response in rheumatoid arthritis: A retrospective study

2019 ◽  
Vol 57 (2) ◽  
pp. 172-182 ◽  
Author(s):  
Tetsuya Hanaka ◽  
Takashi Kido ◽  
Hiroshi Ishimoto ◽  
Keishi Oda ◽  
Shingo Noguchi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Retrospective Study ◽  
Treatment Response ◽  
Pulmonary Involvement ◽  
Radiological Patterns ◽  
Predict Treatment Response

Role of High-Resolution Ultrasound in Detection and Assessment of Disease Activity in Rheumatoid Arthritis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Al Shaymaa Ahmed Mohamed Kassim ◽  
Mohamed Abdel Aziz ◽  
Ahmed Hassan Soliman
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Examination ◽  
Power Doppler ◽  
Joint Effusion ◽  
University Hospitals ◽  
Synovial Hypertrophy ◽  
Small Hands ◽  
Additional Value

Abstract Background Ultrasound imaging is currently a well-known, now frequently used method in the diagnosis of Rheumatoid arthritis. In recent years, it has become an essential supplement of physical examination in Rheumatologist practice. B-mode US & PDUS are very sensitive in detecting synovial hypertrophy, joint effusion, activity, tenosynovitis and any early bony erosions. Aim of the Work to demonstrate the role of Ultrasonography and Power Doppler in proper detection of activity of rheumatoid arthritis in the wrist and small hands joints among different aged population, compared with the laboratory results. Patients and Methods A prospective study was conducted on 40 patients (35 females & 5 males). They were referred from the Rheumatology Department to Ultrasound Unit at Ain Shams University hospitals for US examination of hand and wrist joints mainly. Results In our study, most of the 40 patients enrolled showed one or more of the B-mode or PDUS findings for Rheumatoid Arthritis or its activity. On adding the findings of US & PD to the clinical examination and laboratory protocol of Rheumatoid Arthritis, sensitivity and specificity for diagnosis of disease and disease activity raises. Conclusion Ultrasound and Power Doppler have additional value to clinical examination both in improving early detection of RA and defining true RA remission. B-mode US & PDUS are very sensitive in detecting synovial hypertrophy, joint effusion, activity, tenosynovitis and any early bony erosions.

scholarly journals Correlation With Disease Activity Score 28 (Das28) With Pulmonary Function Test In Rheumatoid Arthritis Patients

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 145-152
Author(s):  
Rameshwar R ◽  
Srujith C. H. ◽  
Jagadeesan M ◽  
Mahendra Kumar ◽  
Prassana Karthik S ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Pulmonary Function ◽  
Disease Activity ◽  
Pulmonary Function Test ◽  
Disease Activity Score ◽  
Pulmonary Involvement ◽  
Pulmonary Complications ◽  
Activity Score ◽  
Unknown Etiology ◽  
Function Test

Rheumatoid Arthritis (RA) is a chronic inflammatory disease of unknown etiology involving both small and large joints with many extra-articular manifestations. There may be a variety of pulmonary complications associated with RA based on its disease activity and levels of RF and anti-CCP titers. Pulmonary involvement may be seen at different levels of the respiratory system, with infection being the most common cause of mortality. Our study shows the association and degree of pulmonary involvement in patients with RA based on the pulmonary function test and its correlation with the DAS 28 score. The aim of our study was to assess the prevalence of pulmonary involvement in patients with Rheumatoid Arthritis. The study population was 100 patients with RA diagnosed based on the 2010 ACR/EULAR criteria following all the exclusion. The patients were subjected to a PFT on diagnosis and repeated at 6 and 18 months following treatment. In our study, there is a higher prevalence of pulmonary involvement seen in doing PFT, even in asymptomatic patients with RA when compared to other studies. Pulmonary complications occurring in patients with Rheumatoid Arthritis may be identified on doing a PFT or HRCT thorax. Pulmonary involvement carries significant mortality and morbidity. Disease duration and disease activity score 28 were found to have a significant association with pulmonary complications. Although our study brings out the incidence of higher risk of pulmonary involvement in patients with RA, more studies meta-analysis are required.

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