Artikel
Pulmonary involvement in patients with Seropositive and ACPA positive Rheumatoid Arthritis – novel screening protocol for early detection of pulmonary involvement
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Autoren
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Florian Popp
- MVZ für Rheumatologie Dr. Martin Welcker GmbH, Planegg
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Martin Hoffmann
- Augustinum Klinik München, Pneumologie, München
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Martin Welcker
- MVZ für Rheumatologie Dr. Martin Welcker GmbH, Planegg
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Werner Von Wulffen
- Augustinum Klinik München, Pneumologie, München
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Frank Reichenberger
- Augustinum Klinik München, Pneumologie, München
| Veröffentlicht: | 30. August 2023 |
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Gliederung
Text
Introduction: Seropositive and ACPA positive Rheumatoid Arthritis (RA) is associated with significant cardiovascular [1] and pulmonary comorbidity [2]. However, screening for early detection of pulmonary involvement especially intestitial lung disease (ILD) in patients with Seropositive and ACPA positive Rheumatoid Arthritis is not established yet.
Methods: Therefore, we used a noninvasive radiation-free approach to screen for pulmonary, pleural or vascular manifestation of the disease by means of pulmonary function test (PFT), cardiopulmonary exercise test (CPET), echocardiography and pleuro-pulmonary transthoracic ultrasound (LUS).
Results: A total of 43 patients (mean age 58.5 years, 81.4% female, 93.02% non-smokers) were included in the data analysis, as data collection was not yet completed at the time of abstract writing. With an average disease duration of 10.1 years, 34.88% showed an erosive course with remission (average DAS28 ESR 2.3, average DAS28 CRP 2.2) respectively low disease activity (average CDAI 6.2, average SDAI 6.6), depending on the used disease activity score. PFT showed in 3 patients (6.98%) a reduced forced vital capacity (FVC≤80%) and in 14 patients (32.56%) a reduced CO-diffusion capacity (DLCOc-SB≤80%). In 39% of patients, we found noticeable changes in LUS, 23% with an ILD-compatible pattern. ILD was supected in 13% having signs on LUS and additional PFT-changes. Numerous other RA- and ILD-associated parameters were collected in the present study (table 1 [Tab. 1] and 2 [Tab. 2]). Other findings included tumor suspected pleural consolidation on ultrasound, severe aortic stenosis in bicuspid aortic valve, severe impaired diffusion capacity due to lung emphysema, pleural effusion and obstructive lung disease. None of the patients showed signs of pulmonary vascular involvement or cardiac ischaemia on echocardiography or CPET.
Conclusion: In conclusion screening of RA-patients for pulmonary involvement is feasible and detects a variety of cardiopulmonary comorbidities.
References
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