Volume 29, Issue 4, 2020
DOI: 10.24205/03276716.2020.895
A Retrospective Study on Clinical Characteristics of Patients with Rheumatoid Arthritis-Interstitial Lung Disease Based on Chest CT Scan
Abstract
Objective: To study the clinical characteristics of patients with rheumatoid arthritis-interstitial lung disease (RA-ILD).
Methods: A total of 120 RA patients undergoing chest CT scan were selected, and their clinical and auxiliary examination data were retrospectively analyzed.
Results: There were 53 RA-ILD patients (44.16%) (RA-ILD group), with an average age of (54.39 ± 11.24) years old, and 67 patients with RA alone (55.83%) (simple RA group) aged (53.21 ± 11.69) on average. The patients were older, the proportions of patients with a course of RA >10 years, and a history of smoking and a history of drug allergy were higher (P<0.05), the joint lesions were severer (P<0.05), the content of serum anti-cyclic citrullinated peptide (CCP) antibody, immunoglobulin G (IgG), IgA and globulin was higher, and the content of complement C4 was lower in RA-ILD group than those in simple RA group (P<0.05). RA-ILD was mainly manifested as cough (35/66.04%), progressive chest tightness (19/35.85%), expectoration (7/13.21%), exertional shortness of breath (11/20.75%), lung wet rales (6/11.32%), lip cyanosis (3/5.66%) and P2>A2 (1/1.89%). Mesh-like shadow (26/55.32%) and ground-glass opacity (8/17.02%) were the main manifestations of RA-ILD in chest X-ray plain films, and the lesions were mostly distributed in the peripheral zone of the two lower lung fields. Mesh-like shadow (31/58.49%), ground-glass opacity (22/41.51%) and fibrous cord-like shadow (17/32.08%) were common chest CT findings, and the lesions were mostly distributed near the pleura in the two mid-lower lung lobes.
Conclusion: RA often involves the lungs, causing ILD. The occurrence of RA-ILD is related to age, course of RA >10 years, histories of smoking and drug allergy, severity of RA and anti-CCP antibody. The proportion of RA-ILD patients without respiratory manifestations is relatively high, and mesh-like shadow, ground-glass opacity and fibrous cord-like shadow are common chest CT findings.
Keywords
rheumatoid arthritis; interstitial lung disease; chest; CT scan; pulmonary function