Some radiological aspects of lung lesions in patients with early rheumatoid arthritis

DOI: https://doi.org/10.29296/25877305-2023-06-09
Issue: 
6
Year: 
2023

D. Bestaev(1, 2), MD; Kh. Mokhamed(1), A. Konushkaliev(1), Z. Brtsieva(1), Candidate of Medical Sciences; N. Burduli(1), Candidate of Medical Sciences; Z. Tsagaraeva(1), T. Bestaeva(2)
1-North Ossetian State Medical Academy, Ministry of Health of Russia, Vladikavkaz
2-“Mega” Medical Center, Vladikavkaz

The early diagnosis of rheumatoid arthritis (RA), the assessment of the severity of its course, and the early prediction of destructive changes are the key to adequate and effective therapy. The modern principles of RA treatment are based on early aggressive therapy at the onset of the disease (the window of opportunity” concept), which allows a sustained remission to be achieved in a number of cases. Lung damage is one of the most common extraarticular manifestations in RA. Lung lesion in the early-stage RA includes respiratory tract damage. Perhaps, the lung should be considered as a place of initiation of the pathological process in RA. The paper gives the results of the study assessing the data of high-resolution tomography of the lung in patients with early RA.
Keywords: 
rheumatology
rheumatoid arthritis
diagnosis
lung lesion
high-resolution computed tomography.

References: 
  1. Беляева И.Б., Мазуров В.И., Трофимова Т.Н. и др. Ранний ревматоидный артрит: современные возможности диагностики и лечения. СПб: Медфорум, 2018; 138 с. [Belyaeva I.B., Mazurov V.I., Trofimova T.N. et al. Rannii revmatoidnyi artrit: sovremennye vozmozhnosti diagnostiki i lecheniya. SPb: Medforum, 2018; 138 р. (in Russ.)].
  2. Хетагурова З.В., Габараева Л.Н., Бестаев Д.В. и др. Состояние эндотелия и свертывающая система крови у больных ревматоидным артритом. Научно-практическая ревматология. 2006; 44 (2): 119 [Khetagurova Z.V., Gabaraeva L.N., Bestaev D.V. et al. State of the endothelium and the blood coagulation system in patients with rheumatoid arthritis. Rheumatology Science and Practice. 2006; 44 (2): 119 (in Russ.)].
  3. Aletaha D., Neogi T., Silman A.J. et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010; 62 (9): 2569–81. DOI: 10.1002/art.27584
  4. Коваленко В.Н., Рекалов Д.Г. Ранняя диагностика ревматоидного артрита: значение инструментальных и лабораторных методов исследования. Украинский ревматологический журнал. 2009; 1 (35): 53–5 [Kovalenko V.N., Recalov D.G. Early diagnostics of rheumatoid arthritis: value of instrumental and laboratory methods. Ukrainskii revmatologicheskii zhurnal. 2009; 1 (35): 53–5 (in Russ.)].
  5. Насонов Е.Л., Мазуров В.И., Каратеев Д.Е. и др. Проект рекомендаций по лечению ревматоидного артрита Ассоциации ревматологов России – 2014 (часть 1). Научно-практическая ревматология. 2014; 52 (5): 477–94 [Nasonov E.L., Mazurov V.I., Karateev D.E. et al. project: recommendations on treatment of rheumatoid arthritis developed by all-Russian public organization «Association of rheumatologists of Russia» – 2014 (part 1). Rheumatology Science and Practice. 2014;52(5):477-494 (in Russ.)]. DOI: 10.14412/1995-4484-2014-477-494
  6. Шостак Н.А., Мурадянц А.А., Логинова Т.К. и др. Клинико-иммунологические особенности раннего ревматоидного артрита. Научно-практическая ревматология. 2004; 42 (1): 15–8 [Shostak N.A., Muradyants A.A., Loginova T.K. et al. Clinical and immunological features of early rheumatoid arthritis. Rheumatology Science and Practice. 2004; 42 (1): 15–8 (in Russ.)]. DOI: 10.14412/1995-4484-2004-1376
  7. McInnes I.B., Schett G. Cytokines in the pathogenesis of rheumatoid arthritis. Nat Rev Immunol. 2007; 7 (6): 429–42. DOI: 10.1038/nri2094
  8. Demoruelle M. Lung abnormalities in subjects with elevations of rheumatoid arthritis-related autoantibodies without arthritis by examination and imaging suggest the lung is an early and perhaps initiating site of inflammation in rheumatoid arthritis. Ann Rheum Dis. 2012; 71 (Suppl 1): A25-A25. DOI: 10.1136/annrheumdis-2011-201231.16
  9. Di Giuseppe D., Discacciati A., Orsini N. et al. Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis. Arthritis Res Ther. 2014; 16 (2): R61. DOI: 10.1186/ar4498
  10. Бестаев Д.В., Божьева Л.А., Волков А.В. и др. Субклиническая форма интерстициального поражения легких при ревматоидном артрите. Клиницист. 2015; 9 (1): 30–6 [Bestaev D.V., Bozhyeva L.A., Volkov A.V. et al. Subclinical interstitial pulmonary injury in rheumatoid arthritis. Klinitsist. 2015; 9 (1): 30–6 (in Russ.)]. DOI: 10.17650/1818-8338-2015-1-30-36
  11. Ascherman D.P. Interstitial lung disease in rheumatoid arthritis. Curr Rheumatol Rep. 2010; 12 (5): 363–9. DOI: 10.1007/s11926-010-0116-z
  12. Gochuico B.R., Avila N.A., Chow C.K. et al. Progressive preclinical interstitial lung disease in rheumatoid arthritis. Arch Intern Med. 2008; 168 (2): 159–66. DOI: 10.1001/archinternmed.2007.59
  13. Weyand C.M., Schmidt D., Wagner U. et al. The influence of sex on the phenotype of rheumatoid arthritis. Arthritis Rheum. 1998; 41 (5): 817–22. DOI: 10.1002/1529-0131(199805)41:5817::AID-ART73.0.CO;2-S
  14. Dong H., Julien P.J., Demoruelle M.K. et al. Interstitial lung abnormalities in patients with early rheumatoid arthritis: A pilot study evaluating prevalence and progression. Eur J Rheumatol. 2019; 6 (4): 193–8. DOI: 10.5152/eurjrheum.2019.19044
  15. Doyle T.J., Dellaripa P.F., Batra K. et al. Functional impact of a spectrum of interstitial lung abnormalities in rheumatoid arthritis. Chest. 2014; 146 (1): 41–50. DOI: 10.1378/chest.13-1394
  16. Gabbay E., Tarala R., Will R. et al. Interstitial lung disease in recent onset rheumatoid arthritis. Am J Respir Crit Care Med. 1997; 156 (2 Pt 1): 528–35. DOI: 10.1164/ajrccm.156.2.9609016
  17. Chen J., Shi Y., Wang X. et al. Asymptomatic preclinical rheumatoid arthritis-associated interstitial lung disease. Clin Dev Immunol. 2013; 2013: 406927. DOI: 10.1155/2013/406927
  18. Dudek M., Kałużna-Oleksy M., Migaj J. et al. Difficult diagnosis of heart failure in rheumatoid arthritis: six-year follow-up of constrictive pericarditis. Kardiol Pol. 2018; 76 (3): 675. DOI: 10.5603/KP.2018.0066
  19. Foster C.S., Forstot S.L., Wilson L.A. Mortality rate in rheumatoid arthritis patients developing necrotizing scleritis or peripheral ulcerative keratitis. Effects of systemic immunosuppression. Ophthalmology. 1984; 91 (10): 1253–63. DOI: 10.1016/s0161-6420(84)34160-4
  20. Санталова Г.В., Бородулина Е.А., Кудлай Д.А. и др. Ревматические заболевания и туберкулезная инфекция у детей и взрослых. Туберкулез и болезни легких. 2019; 97 (2): 50–5 [Santalova G.V., Borodulina E.A., Kudlay D.A. et al. Rheumatic diseases and tuberculosis infection in children and adults. Tuberculosis and Lung Diseases. 2019; 97 (2): 50–5) (in Russ.)] DOI: 10.21292/2075-1230-2019-97-2-50-55
  21. Shaw M., Collins B.F., Ho L.A. et al. Rheumatoid arthritis-associated lung disease. Eur Respir Rev. 2015; 24: 1–16. DOI: 10.1183/09059180.00008014
  22. Kawano-Dourado L., Doyle T.J., Bonfiglioli K. et al. Baseline characteristics and progression of a spectrum of interstitial lung abnormalities and disease in rheumatoid arthritis. Chest. 2020; 158 (4): 1546. DOI: 10.1016/j.chest. 2020.04.061
  23. Dai Y., Wang W., Yu Y. et al. Rheumatoid arthritis–associated interstitial lung disease an overview of epidemiology, pathogenesis and management. Clin Rheumatol. 2021; 40 (4): 1211–220. DOI: 10.1007/s10067-020-05320-z