Prevalencia y características clínicas de la enfermedad pulmonar intersticial difusa sintomática en la artritis reumatoide en una población española / Prevalence and clinical characteristics of symptomatic diffuse interstitial lung disease in rheumatoid arthritis in a Spanish population

Antecedentes y objetivos: En España, los estudios epidemiológicos de prevalencia de enfermedad pulmonar intersticial difusa (EPID) en artritis reumatoide (AR) son escasos y limitados. Nuestro objetivo fue estimar la prevalencia de EPID sintomática en AR y sus características en nuestra área. Materiales y métodos: Se diseñó un estudio observacional longitudinal prospectivo en la consulta interdisciplinar de Reumatología y Neumología, en el que incluimos AR con síntomas respiratorios y EPID confirmada por tomografía computarizada de alta resolución. Resultados: De las 2.729 personas con AR de nuestra área, 47 presentaban EPID sintomática, estimándose una prevalencia de EPID sintomática en AR del 1,72% (intervalo de confianza del 95%: 1,26-2,29) con una edad al diagnóstico de AR de 57,3±13,3 años. Fue más frecuente en hombres, el 60,6% tenía antecedente de tabaquismo y el 84,3 y el 84,7% factor reumatoide y anticuerpos antipéptidos cíclicos citrulinados, respectivamente. El patrón más frecuente fue neumonía intersticial usual (NIU) en 28 (31,1%), la neumonía intersticial no específica (NINE) fue más frecuente en mujeres y el síndrome combinado enfisema-fibrosis (SCEF) exclusivamente en hombres. Conclusiones: En este estudio hemos analizado la prevalencia de AR-EPID sintomática en nuestra área, la cual está por debajo de lo esperado, probablemente en relación con las definiciones utilizadas. Así mismo, hemos descrito que el patrón NIU es el más frecuente en la AR, seguido del NINE y analizado por primera vez la prevalencia de SCEF en la AR, que alcanza el 13% (AU)

Background and objectives: In Spain, epidemiological studies of the prevalence of diffuse interstitial lung disease (ILD) in rheumatoid arthritis (RA) are limited. Our objective was to estimate the prevalence of symptomatic ILD in RA and its characteristics in our area. Materials and methods: In our hospital's interdisciplinary rheumatology and pulmonology clinic, a prospective longitudinal observational study was designed in which we included RA with respiratory symptoms and ILD confirmed by high resolution computed tomography. Results: Of the 2,729 people with RA in our area, 47 had symptomatic ILD, estimating a prevalence of symptomatic ILD in RA of 1.72% (95% CI 1.26 - 2.29) with an age at diagnosis of RA of 57.3±13.3 years. It was more frequent in men, 60.6% had a history of smoking, and 84.3% and 84.7% had rheumatoid factor (RF) and anti-cyclic citrullinated peptide (Anti-CCP) antibodies, respectively. The most frequent pattern was usual interstitial pneumonitis (UIP), appearing in 28 (31.1%). Nonspecific interstitial pneumonia (NSIP) was more frequent in women, while the combined pulmonary fibrosis-emphysema (CPFE) syndrome presented exclusively in men. Conclusions: We have analysed the prevalence of symptomatic RA-ILD in our area, which is lower than expected, probably in relation to the definitions used. We have also described that the UIP pattern is the most frequent in RA in our environment, followed by the NSIP. Lastly, we have analysed the prevalence of CPFE in RA, which reaches 13%, for the first time (AU)

Prevalence and clinical characteristics of symptomatic diffuse interstitial lung disease in rheumatoid arthritis in a Spanish population.

BACKGROUND AND OBJECTIVES: In Spain, epidemiological studies of the prevalence of diffuse interstitial lung disease (ILD) in rheumatoid arthritis (RA) are limited. Our objective was to estimate the prevalence of symptomatic ILD in RA and its characteristics in our area. MATERIALS AND METHODS: In our hospital's interdisciplinary rheumatology and pulmonology clinic, a prospective longitudinal observational study was designed in which we included RA with respiratory symptoms and ILD confirmed by high resolution computed tomography. RESULTS: Of the 2729 people with RA in our area, 47 had symptomatic ILD, estimating a prevalence of symptomatic ILD in RA of 1.72% (95% CI 1.26-2.29) with an age at diagnosis of RA of 57.3 ±â€¯13.3 years. It was more frequent in men, 60.6% had a history of smoking, and 84.3% and 84.7% had rheumatoid factor (RF) and anti-cyclic citrullinated peptide (Anti-CCP) antibodies, respectively. The most frequent pattern was usual interstitial pneumonitis (UIP), appearing in 28 (31.1%). Nonspecific interstitial pneumonia (NSIP) was more frequent in women, while the combined pulmonary fibrosis-emphysema (CPFE) syndrome presented exclusively in men. CONCLUSIONS: We have analysed the prevalence of symptomatic RA-ILD in our area, which is lower than expected, probably in relation to the definitions used. We have also described that the UIP pattern is the most frequent in RA in our environment, followed by the NSIP. Lastly, we have analysed the prevalence of CPFE in RA, which reaches 13%, for the first time.

[Infliximab (anti-TNF-alpha) treatment in patients with adult Still's disease. Experience in 2 cases]. / Tratamiento con infliximab (anti-TNF alfa) en pacientes con enfermedad de Still del adulto. Experiencia de dos casos.

Adult Still's disease is a systemic inflammatory disorder of unknown etiology. First-line treatment for Still's disease includes nonsteroidal anti-inflammatory drugs and corticosteroids. In refractory cases o when the dose of corticosteroid is unacceptably high, other disease modifying antirheumatic drugs have been used. But recent study showed the efficacy anti-TNF therapy in adult Sill's disease refractory to conventional therapy. We report a favourable response to infliximab in two patients who has proved resistant to conventional therapy.