Göðüs Hastanesi Dergisi. Baskýdaki Makaleler: IGHH-92486 | DOI: 10.14744/IGH.2022.92486

Romatoid Artrit ile Ýliþkili Akciðer Hastalýðýnýn Radyolojik ve Klinik Özellikleri

Gazi Gündüz¹, Özgül Soysal Gündüz², Burak Polat^3
1Manisa Þehir Hastanesi, Göðüs Hastalýklarý Kliniði
²Celal Bayar Üniversitesi Týp Fakültesi, Ýç Hastalýklarý Romatoloji Bilim Dalý, Manisa
³Manisa Þehir Hastanesi, Radyoloji Kliniði

Amaç: Romatoid artrit (RA), genellikle sinovyal eklemleri etkileyen, ancak diðer organlarý da etkileyebilen kronik inflamatuar bir hastalýktýr. Romatoid artrit ile iliþkili akciðer hastalýðý (RA-AH) en yaygýn eklem dýþý belirtilerin biri olup, önemli morbidite ve mortaliteye neden olur. RA hastalarýnda pulmoner parankimal hastalýk, plevral inflamasyon, hava yolu hastalýklarý, vaskülit ve pulmoner hipertansiyon gibi çeþitli pulmoner bulgular olabilir. RA hastalarýnda en sýk görülen akciðer hastalýðýnýn interstisyel akciðer hastalýðý (ÝAH) olduðu bildirilmiþtir. Bu çalýþmanýn amacý, tek merkezdeki RA-AH hastalarýnýn tomografik bulgularýný ve bunlarýn hastalýðýn klinik ve laboratuvar bulgularý ile olasý iliþkisini deðerlendirmektir.
Yöntemler: 32 RA-AH hastasýnýn týbbi kayýtlarý geriye dönük olarak incelendi. Radyolojik, klinik ve laboratuvar verileri ile hastalýk aktivitesi skorlarý kaydedildi.
Bulgular: Yaþ ortalamasý 50,23±10,48 yýl olan 32 hasta (%78 kadýn) çalýþmaya dahil edildi. Ortalama hastalýk süresi 52,42±15,48 ay idi. 16 hastada (%50) akciðer grafisinde ve 32 hastanýn tümünde Yüksek Çözünürlüklü Bilgisayarlý Tomografi (YRBT) tetkiklerinde akciðer lezyonlarý tespit edildi. 25 hastada (%78.1) parankim tutulumu saptandý. YRBT taramalarýnda en sýk görülen lezyonlar pulmoner nodüller (%31,2), buzlu cam görünümü (%25) ve bronþektazi (%25) idi. Radyolojik tutulum paternleri ile laboratuvar bulgularý, DAS28-CRP ve ilaçlar arasýnda iliþki bulunmadý (tümü için p > 0.05)
Sonuç: Akciðer grafisinde pulmoner lezyon olmasý durumunda her RA hastasýnda YRBT düþünülmelidir. RA-AH'de parankimal tutulum en sýk görülen paterndir. Ayrýca genç ve kadýn RA hastalarýnda pulmoner nodüller sýk görülebilir.

Anahtar Kelimeler: Romatoid artrit, romatoid artrit iliþkili akciðer hastalýðý, interstisyel akciðer hastalýðý, Yüksek Çözünürlüklü Bilgisayarlý Tomografi

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Radiologic and Clinical Characteristics of Rheumatoid Arthritis-Associated Lung Disease

Gazi Gündüz¹, Özgül Soysal Gündüz², Burak Polat^3
1Department Of Chest Disease, Manisa State Hospital, Turkey
²Department Of Rheumatology, Celal Bayar University, Manisa, Turkey
³Department Of Radiology, Manisa State Hospital, Turkey

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease that usually affects the synovial joints, but can also affect other organs. One of the most common forms of extra-articular manifestations is rheumatoid arthritis-associated lung disease (RA-LD), which causes significant morbidity and mortality. There are several pulmonary findings of RA, including pulmonary parenchymal disease, pleural inflammation, airway diseases, vasculitis, and pulmonary hypertension. It has been reported that the most common pulmonary disease is interstitial lung disease (ILD) in RA patients.The aim of this study is assessing the tomographic findings of RA-LD patients of a single center, and their possible correlation with the clinical and laboratory findings of the disease.
Methods: Medical records of 32 RA-LD patients were investigated retrospectively. The radiological, clinical, and laboratory data, and disease activity and disability scores were recorded.
Results: 32 patients (78% female) with a mean age of 50.23±10.48 years were included in the study. The mean disease duration was 52.42±15.48 months. Pulmonary lesions were detected on chest X-ray in 16 patients (50%) and on High Resolution Computed Tomography (HRCT) scans in all of 32 patients. Parenchymal involvement was detected in 25 patients (78.1%). The most common lesions seen on HRCT scans were pulmonary nodules (31.2%), ground-glass attenuation (25%), and bronchiectasis (25%). No association was found between radiological involvement patterns and laboratory findings, DAS28-CRP, and medications (p > 0.05 for all)
Conclusions: In the presence of a pulmonary lesion on X-ray, HRCT should be considered in every RA patients. Parenchymal involvement is the most common pattern in RA-LD. In addition, pulmonary nodules may be seen frequently in young and female RA patients.

Keywords: Rheumatoid arthritis, rheumatoid arthritis-associated lung disease, interstitial lung disease, High Resolution Computed Tomography

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