Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis
Background/Aims This study aimed to identify the clinical characteristics of patients with concurrent rheumatoid arthritis (RA) and suspected non-tuberculous mycobacterial (NTM) infections as well as determine their prognostic factors. Methods We retrospectively reviewed the medical records of 91 pa...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Korean Association of Internal Medicine
2024-01-01
|
| Series: | The Korean Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://www.kjim.org/upload/kjim-2023-193.pdf |
| _version_ | 1797354436554653696 |
|---|---|
| author | Hyemin Kim Soyoung Lee Ji-Won Kim Ju-Yang Jung Chang-Hee Suh Hyoun-Ah Kim |
| author_facet | Hyemin Kim Soyoung Lee Ji-Won Kim Ju-Yang Jung Chang-Hee Suh Hyoun-Ah Kim |
| author_sort | Hyemin Kim |
| collection | DOAJ |
| description | Background/Aims This study aimed to identify the clinical characteristics of patients with concurrent rheumatoid arthritis (RA) and suspected non-tuberculous mycobacterial (NTM) infections as well as determine their prognostic factors. Methods We retrospectively reviewed the medical records of 91 patients with RA whose computed tomography (CT) findings suggested NTM infection. Subsequently, we compared the clinical characteristics between patients with and without clinical or radiological exacerbation of NTM-pulmonary disease (PD) and investigated the risk factors for the exacerbation and associated mortality. Results The mean age of patients with RA and suspected NTM-PD was 65.0 ± 10.2 years. The nodular/bronchiectatic (NB) form of NTM-PD was the predominant radiographic feature (78.0%). During follow-up, 36 patients (41.9%) experienced a radiological or clinical exacerbation of NTM-PD, whereas 12 patients (13.2%) died. Combined interstitial lung disease (ILD), microbiologically confirmed NTM-PD, and NB with the fibrocavitary (FC) form on chest CT were identified as risk factors for the clinical or radiological exacerbation of NTM-PD. Hydroxychloroquine use was identified as a good prognostic factor. Conversely, history of tuberculosis, ILD, smoking, microbiologically confirmed NTM-PD, and NB with the FC form on chest CT were identified as poor prognostic factors for mortality in suspected NTM-PD. Conclusions ILD and NB with the FC form on chest CT were associated with NTM-PD exacerbation and mortality. Hydroxychloroquine use may lower the risk of NTM-PD exacerbation. Therefore, radiographic features and presence of ILD should be considered when predicting the prognosis of patients with RA and suspected NTM-PD. |
| first_indexed | 2024-03-08T13:49:21Z |
| format | Article |
| id | doaj.art-7be2037d0ee247838017d5819dcd4581 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-03-08T13:49:21Z |
| publishDate | 2024-01-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-7be2037d0ee247838017d5819dcd45812024-01-16T06:39:32ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482024-01-0139117218310.3904/kjim.2023.193170860Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritisHyemin Kim0Soyoung Lee1Ji-Won Kim2Ju-Yang Jung3Chang-Hee Suh4Hyoun-Ah Kim5Department of Rheumatology, Ajou University School of Medicine, Suwon, KoreaDepartment of Rheumatology, Ajou University School of Medicine, Suwon, KoreaDepartment of Rheumatology, Ajou University School of Medicine, Suwon, KoreaDepartment of Rheumatology, Ajou University School of Medicine, Suwon, KoreaDepartment of Rheumatology, Ajou University School of Medicine, Suwon, KoreaDepartment of Rheumatology, Ajou University School of Medicine, Suwon, KoreaBackground/Aims This study aimed to identify the clinical characteristics of patients with concurrent rheumatoid arthritis (RA) and suspected non-tuberculous mycobacterial (NTM) infections as well as determine their prognostic factors. Methods We retrospectively reviewed the medical records of 91 patients with RA whose computed tomography (CT) findings suggested NTM infection. Subsequently, we compared the clinical characteristics between patients with and without clinical or radiological exacerbation of NTM-pulmonary disease (PD) and investigated the risk factors for the exacerbation and associated mortality. Results The mean age of patients with RA and suspected NTM-PD was 65.0 ± 10.2 years. The nodular/bronchiectatic (NB) form of NTM-PD was the predominant radiographic feature (78.0%). During follow-up, 36 patients (41.9%) experienced a radiological or clinical exacerbation of NTM-PD, whereas 12 patients (13.2%) died. Combined interstitial lung disease (ILD), microbiologically confirmed NTM-PD, and NB with the fibrocavitary (FC) form on chest CT were identified as risk factors for the clinical or radiological exacerbation of NTM-PD. Hydroxychloroquine use was identified as a good prognostic factor. Conversely, history of tuberculosis, ILD, smoking, microbiologically confirmed NTM-PD, and NB with the FC form on chest CT were identified as poor prognostic factors for mortality in suspected NTM-PD. Conclusions ILD and NB with the FC form on chest CT were associated with NTM-PD exacerbation and mortality. Hydroxychloroquine use may lower the risk of NTM-PD exacerbation. Therefore, radiographic features and presence of ILD should be considered when predicting the prognosis of patients with RA and suspected NTM-PD.http://www.kjim.org/upload/kjim-2023-193.pdfrheumatoid arthritisnontuberculous mycobacteriaprognosisrisk factor |
| spellingShingle | Hyemin Kim Soyoung Lee Ji-Won Kim Ju-Yang Jung Chang-Hee Suh Hyoun-Ah Kim Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis The Korean Journal of Internal Medicine rheumatoid arthritis nontuberculous mycobacteria prognosis risk factor |
| title | Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis |
| title_full | Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis |
| title_fullStr | Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis |
| title_full_unstemmed | Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis |
| title_short | Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis |
| title_sort | clinical characteristics and prognostic factors of non tuberculous mycobacterial disease in patients with rheumatoid arthritis |
| topic | rheumatoid arthritis nontuberculous mycobacteria prognosis risk factor |
| url | http://www.kjim.org/upload/kjim-2023-193.pdf |
| work_keys_str_mv | AT hyeminkim clinicalcharacteristicsandprognosticfactorsofnontuberculousmycobacterialdiseaseinpatientswithrheumatoidarthritis AT soyounglee clinicalcharacteristicsandprognosticfactorsofnontuberculousmycobacterialdiseaseinpatientswithrheumatoidarthritis AT jiwonkim clinicalcharacteristicsandprognosticfactorsofnontuberculousmycobacterialdiseaseinpatientswithrheumatoidarthritis AT juyangjung clinicalcharacteristicsandprognosticfactorsofnontuberculousmycobacterialdiseaseinpatientswithrheumatoidarthritis AT changheesuh clinicalcharacteristicsandprognosticfactorsofnontuberculousmycobacterialdiseaseinpatientswithrheumatoidarthritis AT hyounahkim clinicalcharacteristicsandprognosticfactorsofnontuberculousmycobacterialdiseaseinpatientswithrheumatoidarthritis |