Clinical characteristics of rheumatoid arthritis with interstitial pulmonary fibrosis / 北京大学学报(医学版)

ABSTRACT

Objective:To analyze the clinical characteristics of interstitial pulmonary fibrosis (IPF) in patients with Rheumatoid arthritis (RA). Methods: We retrospectively analyzed 198 RA patients with or without IPF. Characteristics of RA-IPF in clinical and lab data were analyzed. Age, duration of disease,clinical and laboratory parameters, history of smoking and medicine were compared between the patients with and without IPF. Results: (1) Among the 198 RA patients, 15.2% (30/198) were found with IPF. 100% RA-IPF patients had HRCT findings. However, 63.3% (19/30) had positive findings in chest X-ray, and only 46. 7% ( 14/30) had the complaints of cough and short breath. Velcro rales were found in 50.0% (15/30) patients with IPF and no acropachy occurred. Only one patient suffered from hypoxemia. IPF presented after the joint symptoms in most patients. (2 ) RA-IPF patients were older than those without IPF [(65.50±9.71) vs (55.22±12.98) years, P＜0.01]; Higher positivity of anti-keratin antibodies ( AKA) were found in RA-IPF compared to patients without IPF (61. 5% vs 35.9% , P =0.014). Furthermore, the levels of anti-cyclic citrullinated peptide (CCP) antibody were significantly higher in RA-IPF [(4.38±2.08) vs (3.20±2. 12) , P =0.01]. No differentiation of duration of disease, history of smoking and medicine, IgM rheumatoid factor, IgG rheumatoid factor, anti-nuclear antibody, anti-SSA antibody and levels of immunoglobins and complements were found between the two groups of RA patients with and without IPF. Conclusion: The clinical symptoms of IPF in RA patients are mild and more common in older patients. AKA and anti-CCP antibody might be important antibodies associated with RA-IPF.