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- Title
Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay.
- Authors
das Posses Bridi, Guilherme; Yamada Sawamura, Márcio Valente; Wanderley, Mark; Soares Souza, Luciana Volpon; Kairalla, Ronaldo Adib; Kawano-Dourado, Letícia; Baldi, Bruno Guedes
- Abstract
Rheumatoid arthritis (RA) is an autoimmune inflammatory and heterogeneous disease that affects several systems, especially the joints. Among the extra-articular manifestations of RA, pleuropulmonary involvement occurs frequently, with different presentations, potentially in all anatomic thoracic compartments, and may determine high morbidity and mortality. The most common pleuropulmonary manifestations in patients with RA include interstitial lung disease (ILD), pleural disease, pulmonary arterial hypertension, rheumatoid lung nodules, airway disease (bronchiectasis and bronchiolitis), and lymphadenopathy. Pulmonary hypertension and ILD are the manifestations with the greatest negative impact in prognosis. HRCT of the chest is essential in the evaluation of patients with RA with respiratory symptoms, especially those with higher risk factors for ILD, such as male gender, smoking, older age, high levels of rheumatoid factor, or positive anti-cyclic citrullinated peptide antibody results. Additionally, other etiologies that may determine tomographic pleuropulmonary manifestations in patients with RA are infections, neoplasms, and drug-induced lung disease. In these scenarios, clinical presentation is heterogeneous, varying from being asymptomatic to having progressive respiratory failure. Knowledge on the potential etiologies causing tomographic pleuropulmonary manifestations in patients with RA coupled with proper clinical reasoning is crucial to diagnose and treat these patients.
- Subjects
INTERSTITIAL lung diseases; PULMONARY arterial hypertension; PULMONARY nodules; PULMONARY hypertension; LUNG diseases; RHEUMATOID arthritis; BRONCHIECTASIS
- Publication
Brazilian Journal of Pulmonology / Jornal Brasileiro de Pneumologia, 2023, Vol 49, Issue 1, p1
- ISSN
1806-3713
- Publication type
Article
- DOI
10.36416/1806-3756/e20220466