title: Preclinical lung disease in early rheumatoid arthritis.
abstract: Early detection and treatment of lung disease in patients with rheumatoid arthritis (RA) may ameliorate disease progression. The objectives of this study were to investigate the frequency of asymptomatic lung abnormalities in early RA patients and the potential association of positive RA blood reactive biomolecules with lung involvement. A prospective observational study was performed in a cohort of patients with early RA (joint symptoms < 2 years) without respiratory symptoms, who were included in a screening program for lung disease with a baseline chest radiograph (CR) and complete pulmonary function tests (PFTs). In those patients with lung abnormalities on the CR or PFTs, a high-resolution chest computed tomography scan (HRCT) was performed. We included 40 patients (30 women). Altered PFTs were detected in 18 (45%) of these patients. These cases had a diffusion lung transfer capacity of carbon monoxide (DLCO) of <80% of predicted, without a significant reduction in the forced vital capacity. The HRCT detected abnormalities in 11 of the 18 patients. Diffuse bronchiectasis was the main finding. An inverse correlation between the anti-citrullinated peptide antibody (ACPA) levels and DLCO was found. Asymptomatic lung disease is present in up to 45% of early RA patients and can be determined by PFTs and ACPA levels.
authors: Department of Pneumology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain a_roblesperez@hotmail.com.
authors: Alejandro
authors: A
authors: Robles-Perez
authors: Servei de Diagnòstic per la Imatge El Prat (SDPI El Prat), Department of Radiology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
authors: Patricio
authors: P
authors: Luburich
authors: Department of Pneumology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
authors: Benigno
authors: B
authors: Rodriguez-Sanchon
authors: Department of Pneumology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain CIBER de Enfermedades Respiratorias (CIBERES).
authors: Jordi
authors: J
authors: Dorca
authors: Department of Rheumatology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
authors: Joan Miquel
authors: JM
authors: Nolla
authors: Department of Pneumology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain CIBER de Enfermedades Respiratorias (CIBERES).
authors: Maria
authors: M
authors: Molina-Molina
authors: Department of Rheumatology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
authors: Javier
authors: J
authors: Narvaez-Garcia
mesh_terms: D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications*; D001987:Bronchiectasis / Q000175:diagnosis; D002248:Carbon Monoxide / Q000032:analysis; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D011653:Pulmonary Diffusing Capacity; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed
chemical_list: D002248:Carbon Monoxide
keywords: Arthritis; autoantibodies; lung diseases; multidetector computed tomography; respiratory function tests; rheumatoid