Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics

Interstitial lung disease (ILD) represents a severe manifestation in connective tissue diseases (CTD), with an overall incidence of 15%, and it is still a challenge for clinicians evaluation and management. ILD is the most common manifestation of lung involvement in Rheumatoid Arthritis (RA), obser...

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Main Authors: A. Picchianti Diamanti, V. Germano, E. Bizzi, B. Laganà, A. Migliore
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Pulmonary Medicine
Online Access:http://dx.doi.org/10.1155/2011/931342
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author A. Picchianti Diamanti
V. Germano
E. Bizzi
B. Laganà
A. Migliore
author_facet A. Picchianti Diamanti
V. Germano
E. Bizzi
B. Laganà
A. Migliore
author_sort A. Picchianti Diamanti
collection DOAJ
description Interstitial lung disease (ILD) represents a severe manifestation in connective tissue diseases (CTD), with an overall incidence of 15%, and it is still a challenge for clinicians evaluation and management. ILD is the most common manifestation of lung involvement in Rheumatoid Arthritis (RA), observed in up to 80% of biopsies, 50% of chest Computed Tomography (CT) and only 5% of chest radiographs. Histopatological patterns of ILD in RA may present with different patterns, such as: usual interstitial pneumonia, non specific interstitial pneumonia, desquamative interstitial pneumonia, organizing pneumonia, and eosinophilic infiltration. The incidence of ILD in RA patients is not only related to the disease itself, many drugs may be in fact associated with the development of pulmonary damage. Some reports suggest a causative role for TNFα inhibitors in RA-ILD development/worsening, anyway, no definitive statement can be drawn thus data are incomplete and affected by several variables. A tight control (pulmonary function tests and/or HRCT) is mandatory in patients with preexisting ILD, but it should be also performed in those presenting risk factors for ILD and mild respiratory symptoms. Biologic therapy should be interrupted, and, after excluding triggering infections, corticosteroids should be administered.
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series Pulmonary Medicine
spelling doaj-art-1fe6f6a7cd394d37a2fa0e166c60e7292025-08-20T03:54:34ZengWileyPulmonary Medicine2090-18362090-18442011-01-01201110.1155/2011/931342931342Interstitial Lung Disease in Rheumatoid Arthritis in the Era of BiologicsA. Picchianti Diamanti0V. Germano1E. Bizzi2B. Laganà3A. Migliore4Chair and Division of Allergy, Clinical Immunology, and Rheumatology, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, ItalyChair and Division of Allergy, Clinical Immunology, and Rheumatology, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, ItalyUnit of Rheumatology, “S. Peter Hospital FBF” and Research Center “S. Pietro AfaR”, 00100 Rome, ItalyChair and Division of Allergy, Clinical Immunology, and Rheumatology, S. Andrea University Hospital, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, ItalyUnit of Rheumatology, “S. Peter Hospital FBF” and Research Center “S. Pietro AfaR”, 00100 Rome, ItalyInterstitial lung disease (ILD) represents a severe manifestation in connective tissue diseases (CTD), with an overall incidence of 15%, and it is still a challenge for clinicians evaluation and management. ILD is the most common manifestation of lung involvement in Rheumatoid Arthritis (RA), observed in up to 80% of biopsies, 50% of chest Computed Tomography (CT) and only 5% of chest radiographs. Histopatological patterns of ILD in RA may present with different patterns, such as: usual interstitial pneumonia, non specific interstitial pneumonia, desquamative interstitial pneumonia, organizing pneumonia, and eosinophilic infiltration. The incidence of ILD in RA patients is not only related to the disease itself, many drugs may be in fact associated with the development of pulmonary damage. Some reports suggest a causative role for TNFα inhibitors in RA-ILD development/worsening, anyway, no definitive statement can be drawn thus data are incomplete and affected by several variables. A tight control (pulmonary function tests and/or HRCT) is mandatory in patients with preexisting ILD, but it should be also performed in those presenting risk factors for ILD and mild respiratory symptoms. Biologic therapy should be interrupted, and, after excluding triggering infections, corticosteroids should be administered.http://dx.doi.org/10.1155/2011/931342
spellingShingle A. Picchianti Diamanti
V. Germano
E. Bizzi
B. Laganà
A. Migliore
Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics
Pulmonary Medicine
title Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics
title_full Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics
title_fullStr Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics
title_full_unstemmed Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics
title_short Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics
title_sort interstitial lung disease in rheumatoid arthritis in the era of biologics
url http://dx.doi.org/10.1155/2011/931342
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