title: Asymptomatic preclinical rheumatoid arthritis-associated interstitial lung disease.
abstract: OBJECTIVE
  Interstitial lung disease (ILD) is a common extra-articular manifestation of rheumatoid arthritis (RA) and a significant cause of morbidity and mortality. The objective of this study was to define high-resolution chest CT (HRCT) and pulmonary function test (PFT) abnormalities capable of identifying asymptomatic, preclinical forms of RA-ILD that may represent precursors to more severe fibrotic lung disease.
  
  
  METHODS
  We analyzed chest HRCTs in consecutively enrolled RA patients and subsequently classified these individuals as RA-ILD or RA-no ILD based on the presence/absence of ground glass opacification, septal thickening, reticulation, traction bronchiectasis, and/or honeycombing. Coexisting PFT abnormalities (reductions in percent predicted FEV1, FVC, TLC, and/or DLCO) were also used to further characterize occult respiratory defects.
  
  
  RESULTS
  61% (63/103) of RA patients were classified as RA-ILD based on HRCT and PFT abnormalities, while 39% (40/103) were designated as RA-no ILD. 57/63 RA-ILD patients lacked symptoms of significant dyspnea or cough at the time of HRCT and PFT assessment. Compared with RA-no ILD, RA-ILD patients were older and had longer disease duration, higher articular disease activity, and more significant PFT abnormalities.
  
  
  CONCLUSIONS
  HRCT represents an effective tool to detect occult/asymptomatic ILD that is highly prevalent in our unselected, university-based cohort of RA patients.
authors: Rheumatology Department of the First Hospital of Xiamen University, Zhen Hai Road No. 55, Xiamen 361003, China. juan10501@hotmail.com
authors: Juan
authors: J
authors: Chen
authors: YongHong
authors: Y
authors: Shi
authors: XiaoPing
authors: X
authors: Wang
authors: Heqing
authors: H
authors: Huang
authors: Dana
authors: D
authors: Ascherman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D017563:Lung Diseases, Interstitial / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed; D055815:Young Adult
references: Chest. 2009 Nov;136(5):1397-1405
references: 19892679
references: Eur Radiol. 2004 Feb;14(2):272-80
references: 14557895
references: Pulm Med. 2011;2011:872120
references: 21660199
references: Arch Intern Med. 2008 Jan 28;168(2):159-66
references: 18227362
references: Am Rev Respir Dis. 1991 Nov;144(5):1202-18
references: 1952453
references: Rheumatol Int. 2012 Mar;32(3):669-73
references: 21132550
references: Pulm Med. 2011;2011:931342
references: 22229089
references: Arthritis Rheum. 1988 Mar;31(3):315-24
references: 3358796
references: Curr Rheumatol Rep. 2010 Oct;12(5):363-9
references: 20628839
references: Rheumatology (Oxford). 2009 Sep;48(9):1069-72
references: 19321513
references: Rev Mal Respir. 2008 Oct;25(8):973-88
references: 18971804
references: Eur Respir J. 2010 Jun;35(6):1322-8
references: 19996193
references: Arthritis Rheum. 2010 Jun;62(6):1583-91
references: 20155830