Chest
Clinical InvestigationsHistopathologic Pattern and Clinical Features of Rheumatoid Arthritis-Associated Interstitial Lung Disease
Section snippets
Patients
This is a retrospective study performed at Asan Medical Center, a 2,000-bed, university-affiliated, tertiary referral center in Seoul, Korea. A computer-aided search revealed 42 patients with an RA-ILD diagnosis from January 1991 to November 2002; 18 of these patients underwent SLBx. We have had a policy of performing SLBx on all patients with clinically significant diffuse lung diseases to get a definitive diagnosis. The major reason we could not perform the SLBx was that patients refused to
Histologic Diagnosis
The κ coefficient of agreement between the pathologists (M.K. and T.V.C. for example) for the differentiation of UIP and NSIP patterns was 0.63. The most frequent histopathologic pattern was UIP (55.6%) [Table 1; Fig 1]. The NSIP pattern was found in six patients (mixed cellular and fibrotic NSIP in two patients, fibrotic NSIP in four patients) [Fig 2], and inflammatory airway disease (IAD) combined with an organizing pneumonia (OP) pattern were seen in two patients. One patient with IAD
Discussion
This study shows that the distribution of histopathologic patterns in RA-ILD was different than in other types of CVD-ILD, with the UIP pattern being more prevalent than NSIP pattern. We also found that IAD was one of important manifestations in RA patents, as reported in previous studies.14151617 Death occurred only in the UIP group, and all patients with NSIP were alive and improved or stable in this small series.
Our finding of a more prevalent UIP pattern in RA compared to the NSIP pattern
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