scholarly journals Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis: Spanish RA-ILD cohort

2020 ◽  
Author(s):  
Esteban Cano-Jiménez ◽  
Tomás Vázquez Rodríguez ◽  
Irene Martín-Robles ◽  
Diego Castillo Villegas ◽  
Javier Juan García ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Independent Predictor ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Systemic Autoimmune Disease ◽  
Cross Sectional ◽  
Evolution Characteristics ◽  
Cox Analysis

Abstract Introduction: Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. Methods: A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD between 2013 and 2018. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. Results: 106 patients were included. The mean age was 70.2±19.8 years and 51.9% of the patients presented UIP pattern. In the multivariate Cox analysis the age (HR 1.33, 95% CI 1.09-1.62, p=0.0045), the DLCO (%) (HR 0.85, 95% CI 0.73-0.98, p=0.0246), and the final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39-0.99, p=0.0465) were independent predictor variables of mortality, as well as the GAP index (HR 4.65, 95% CI 1.59 - 13.54, p=0.0051) and the CPI index (HR 1.12, 95% CI 1.03 - 1.22, p=0.0092). Also highlight that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01-1.23, p = 0.035). Conclusions: This is the first study where it is objectified that the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.

scholarly journals Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Esteban Cano-Jiménez ◽  
Tomás Vázquez Rodríguez ◽  
Irene Martín-Robles ◽  
Diego Castillo Villegas ◽  
Javier Juan García ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Independent Predictor ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Systemic Autoimmune Disease ◽  
Cross Sectional ◽  
Evolution Characteristics ◽  
Cox Analysis

AbstractRheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01–1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09–1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73–0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39–0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59–13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03–1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14–4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.

scholarly journals Anti-carbamylated proteins antibody repertoire in rheumatoid arthritis: evidence of a new autoantibody linked to interstitial lung disease

2020 ◽  
Vol 79 (5) ◽  
pp. 587-594 ◽  
Author(s):  
Raul Castellanos-Moreira ◽  
Sebastian Cruz Rodríguez-García ◽  
Maria Jose Gomara ◽  
Virginia Ruiz-Esquide ◽  
Andrea Cuervo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Calf Serum ◽  
Cross Sectional Study ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Replication Sample ◽  
Group 2 ◽  
Diagnostic Work

ObjectiveTo analyse the association between anti-carbamylated protein antibodies (Anti-CarP) and interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients.MethodsCross-sectional study including RA patients fulfilling the 2010 ACR/EULAR criteria. The main population comprised two groups: (1) RA patients diagnosed with RA-ILD (RA-ILD group); (2) RA patients without ILD (non-ILD RA group). Non-ILD RA patients in whom ILD was suspected underwent a diagnostic work-up and, if ILD was diagnosed, were switched to the RA-ILD group. ILD was diagnosed by high-resolution computed tomography and confirmed by a multidisciplinary committee. An independent replication sample was also obtained. Three Anti-CarP IgG autoantibodies against fetal calf serum (Anti-FCS), fibrinogen (Anti-Fib) and chimeric fibrine/filagrine homocitrullinated peptide (Anti-CFFHP) and one Anti-CarP IgA against FCS (Anti-FCS-IgA) were determined by home-made ELISA. Associations between Anti-CarP and ILD were analysed using multivariable logistic regression adjusted by smoking, sex, age, RA disease duration, rheumatoid factor and anticitrullinated protein antibodies.ResultsWe enrolled 179 patients: 37 (21%) were finally diagnosed with RA-ILD. Anti-CarP specificities were more frequent in RA-ILD patients (Anti-FCS 70% vs 43%; Anti-Fib 73% vs 51%; Anti-CFFHP 38% vs 19%; Anti-CarP-IgA 51% vs 20%, p<0.05 for all comparisons). Serum titers of Anti-CarP were significantly higher in RA-ILD patients. Anti-CarP specificities showed a robust effect towards increasing the odds of ILD in the multivariate analysis (Anti-FCS (OR: 3.42; 95% CI: 1.13 to 10.40), Anti-Fib (OR: 2.85; 95% CI: 0.83 to 9.70), Anti-CFFHP (OR: 3.11; 95% CI: 1.06 to 9.14) and Anti-FCS-IgA (OR: 4.30; 95% CI: 1.41 to 13.04)). Similar findings were observed in the replication sample.ConclusionsAnti-CarP were strongly associated with ILD. The role of homocitrullination in RA-ILD merits further investigation.

scholarly journals A STUDY OF INTERSTITIAL LUNG DISEASE ASSOCIATED WITH RHEUMATOID ARTHRITIS

2021 ◽  
pp. 1-2
Author(s):  
R.Belinda Anet ◽  
Jai Kishan ◽  
Sameer Singhal
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Pulmonary Function Tests ◽  
Systemic Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Radiological Patterns ◽  
Laboratory Profile ◽  
Restrictive Pattern

BACKGROUND: Rheumatoid Arthritis (RA) is a common systemic disease that manifests as inflammatory arthritis of multiple joints and produces a wide variety of extra-articular manifestations. Interstitial Lung Disease (ILD) is one of the important pulmonary manifestation of RA like other Connective Tissue Disease(CTD). However RA-ILD differs from CTD-ILD in terms of histopathology and prognosis. OBJECTIVES: To study the clinical features, laboratory profile, radiological patterns, pulmonary function tests including spirometry and DLCO in patients with RA-ILD. MATERIALS AND METHODS: This study was a cross sectional study carried out in the department of Respiratory Medicine at MMIMSR,Mullana, Haryana. A total of 10 patients were included in the study after verifying inclusion and exclusion criteria. After complete history and investigations details were documented in a proforma. RESULTS: A total of 10 patients comprising of 3 males and 7 females with a mean age of 56.5 years were included. Dry cough (100%) was the most common presenting complaints followed by excertional dyspnoea (80%). Among the 10 patients 8 were smokers. Bilateral basal Velcro creps was the most common feature (70%) followed by clubbing(20%).In HRCT the most common pattern was UIP (typical UIP-10%, probable UIP-70%) followed by Non-IPF pattern (20%). Spirometry showed restrictive pattern in all cases. DLCO was severely reduced in typical UIP pattern. CONCLUSION: HRCT chest is the most sensitive tool for early diagnosis of ILD, while DLCO is most sensitive for monitoring the prognosis. RA-ILD can be prevented and treated at an early state.

scholarly journals Correlation between Lung and Joint Involvement in Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Cross-Sectional Study

2018 ◽  
Vol 70 (2) ◽  
Author(s):  
Francisco Paulin ◽  
Juan Mercado ◽  
Martín Eduardo Fernández ◽  
Fabián Caro ◽  
María Laura Alberti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Cross Sectional Study ◽  
Joint Involvement ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Interstitial Lung Disease and Depression – A Questionnaire Based Study

BioMedica ◽  
2020 ◽  
Vol 36 (4) ◽  
pp. 374-378
Author(s):  
Muntazir Mehdi ◽  
Muhammad Waseem ◽  
Dr. Hafiza Swaiba Afzal ◽  
Ahmad Zeeshan Jamil ◽  
Muhammad Junaid Iqbal ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Beck Depression Inventory ◽  
Lower Class ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Socioeconomic Groups ◽  
Depressed Patients ◽  
Prevalence Of Depression

Background and Objective: Interstitial lung disease (ILD) causes depression due to its painful course in patients. The aim of this study was to determine the prevalence of depression and find the association of depression with selected clinical variables in patients with ILD. Methods: This questionnaire based cross-sectional study was done at the department of pulmonology, District head quarter hospital Sahiwal from 1st Oct 2019 to 31st March 2020. The questionnaire was distributed among the diagnosed cases of ILD who presented in outpatient department of DHQ Sahiwal after taking informed consent. The depression scoring was done in them according to Beck depression inventory II. Frequency distribution statistics and inferential statistics were done by using Statistical Package for Social Sciences (SPSS) version 20. P-value < 0.05 was taken as statistically significant. Results: Depression was graded into four types according to Beck depression inventory II scoring system. Depression levels of minimal, mild, severe and extremely severe were found to have frequencies of 42.90, 14.30, 31.40 and 11.4% respectively. Depression was more prevalent in females (77.14%). Sixty two percent of severely depressed had rural background. Three fourth (75%) of severely depressed patients were from lower class group. Half of the severely depressed patients were suffering from hypertension. One fourth had ischemic heart disease. Illiteracy dominated in severely depressed where 3/4th of the participants had not received any education. Our study found statistically significant result of Beck score with socioeconomic groups (P = 0.037). High statistically significant result was also found when Beck scoring was associated with co-morbidities (P = 0.001). Conclusions: The increased frequency of depression in the patients of ILD was associated with many demographic factors. The development of improved methods for the assessment of ILD and its co-morbidities could have profound effects on the quality of life and expected survival of ILD patients.

scholarly journals A Comparative Study of the Sarcopenia Screening in Older Patients with Interstitial Lung Disease

2021 ◽  
Author(s):  
Masatoshi Hanada ◽  
Noriho Sakamoto ◽  
Hiroshi Ishimoto ◽  
Takashi Kido ◽  
Takuto Miyamura ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Operating Characteristic ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Calf Circumference ◽  
Sectional Study ◽  
Cross Sectional ◽  
Receiver Operating Characteristic Curves ◽  
Climbing Stairs

Abstract Background: The calf circumference (CalF), the strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) and the SARC-CalF questionnaires for sarcopenia screening have been used by Asian Working Group for Sarcopenia 2019 (AWGS 2019). The aim of this study was to assess accuracy of these three sarcopenia screening tools in patients with interstitial lung disease. Methods: In this cross-sectional study, stable patients with interstitial lung disease were enrolled. The SARC-F, SARC-CalF, and CalF, used in patients with interstitial lung disease, were compared to the diagnostic criteria proposed by AWGS 2019. The accuracy of screening tools was compared using sensitivity and specificity. Moreover, areas under the receiver operating characteristic curves (AUC) were computed. Results: Seventy eight patients were analyzed, and sarcopenia was identified in 25 (32.1%) patients with interstitial lung disease by the AWGS 2019 criteria. The sensitivity of the CalF was highest (96%) of the three screening tools, while the specificity was 60%. The sensitivity of SARC-F and SARC-CalF were 24% and 68%, while the specificity were 92% and 66%, respectively. The AUCs of CalF, SARC-F, and SARC-CalF in all patients were 0.78, 0.58, and 0.67, respectively. Conclusions: The CalF is most suitable for screening sarcopenia in patients with interstitial lung disease, while SARC-F and SARC-CalF are not.

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