Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay
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 tho...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Pneumologia e Tisiologia
2023-01-01
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| Series: | Jornal Brasileiro de Pneumologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132023000100700&lng=en&tlng=en |
| _version_ | 1811164870520864768 |
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| author | Guilherme das Posses Bridi Márcio Valente Yamada Sawamura Mark Wanderley Luciana Volpon Soares Souza Ronaldo Adib Kairalla Letícia Kawano-Dourado Bruno Guedes Baldi |
| author_facet | Guilherme das Posses Bridi Márcio Valente Yamada Sawamura Mark Wanderley Luciana Volpon Soares Souza Ronaldo Adib Kairalla Letícia Kawano-Dourado Bruno Guedes Baldi |
| author_sort | Guilherme das Posses Bridi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T15:29:11Z |
| format | Article |
| id | doaj.art-8217a033d3bb456797f0af891d92680a |
| institution | Directory Open Access Journal |
| issn | 1806-3756 |
| language | English |
| last_indexed | 2024-04-10T15:29:11Z |
| publishDate | 2023-01-01 |
| publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
| record_format | Article |
| series | Jornal Brasileiro de Pneumologia |
| spelling | doaj.art-8217a033d3bb456797f0af891d92680a2023-02-14T07:32:18ZengSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia1806-37562023-01-0149110.36416/1806-3756/e20220466Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essayGuilherme das Posses Bridihttps://orcid.org/0000-0002-0771-3703Márcio Valente Yamada Sawamurahttps://orcid.org/0000-0002-9424-9776Mark Wanderleyhttps://orcid.org/0000-0003-2023-7163Luciana Volpon Soares Souzahttps://orcid.org/0000-0002-2541-7748Ronaldo Adib Kairallahttps://orcid.org/0000-0001-7194-0479Letícia Kawano-Douradohttps://orcid.org/0000-0003-0784-1331Bruno Guedes Baldihttps://orcid.org/0000-0002-9609-5117ABSTRACT 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132023000100700&lng=en&tlng=enLung diseases, interstitialLung diseasesPleural diseasesPulmonary arterial hypertensionArthritis, rheumatoidTomography |
| spellingShingle | Guilherme das Posses Bridi Márcio Valente Yamada Sawamura Mark Wanderley Luciana Volpon Soares Souza Ronaldo Adib Kairalla Letícia Kawano-Dourado Bruno Guedes Baldi Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay Jornal Brasileiro de Pneumologia Lung diseases, interstitial Lung diseases Pleural diseases Pulmonary arterial hypertension Arthritis, rheumatoid Tomography |
| title | Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay |
| title_full | Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay |
| title_fullStr | Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay |
| title_full_unstemmed | Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay |
| title_short | Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay |
| title_sort | tomographic pleuropulmonary manifestations in rheumatoid arthritis a pictorial essay |
| topic | Lung diseases, interstitial Lung diseases Pleural diseases Pulmonary arterial hypertension Arthritis, rheumatoid Tomography |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132023000100700&lng=en&tlng=en |
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