Interstitial lung disease in Egyptian patients with rheumatoid arthritis: Frequency, pattern and correlation with clinical manifestations and anti-citrullinated peptide antibodies level

• Published in: Egyptian rheumatologist 2018-07, Vol.40 (3), p.155-160
• Main Authors: Fadda, Samia, Khairy, Nermeen, Fayed, Hala, Mousa, Heba, Taha, Radwa
• Format: Article
• Language: English
• Subjects: ACPA titer; CDAI; Interstitial lung disease; MHAQ; Rheumatoid arthritis
• ISSN: 1110-1164; 2090-2433
• DOI: 10.1016/j.ejr.2017.10.006

Interstitial lung disease (ILD) represents 13% of the overall mortality in rheumatoid arthritis (RA) patients. To determine the frequency and pattern of ILD among RA patients, correlate it with clinical manifestations and with anti-citrullinated peptide antibodies (ACPA) titer. This study included 88 RA patients. ILD was diagnosed by high-resolution computed tomography (HRCT) and assessed by a severity score. Disease activity was assessed by clinical disease activity index (CDAI) and functional status by the modified health assessment questionnaire (MHAQ). Serum ACPA titer was assayed by ELISA. The mean age of the patients was 50.15±9 years, disease duration was 10.2±6.2 years and they were 75 females and 13 males. ACPA was positive in 84 (95.5%). The frequency of ILD among RA patients was 71.6%. ILD patterns were: usual interstitial pneumonia (UIP) 62%, non-specific interstitial pneumonia (NSIP) 27%, others (Cryptogenic and mixed) in 11%. In RA-ILD, the mean ACPA titer was 225±121.5 U/mL versus 154.3 ±121.8 U/mL in RA only. In RA-ILD, ACPA titer negatively correlated with morning stiffness, CDAI, MHAQ and six-minute walk test (r=−0.3, p=.008, r=−0.6, p