Rheumatoid Arthritis (RA) associated interstitial lung disease (ILD).
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Authors
O'Dwyer, David NArmstrong, Michelle E
Cooke, Gordon
Dodd, Jonathan D
Veale, Douglas J
Donnelly, Seamas C
Affiliation
School of Medicine and Medical Science, College of Life Sciences, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland; National Pulmonary Fibrosis Referral Centre at St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.Issue Date
2013-10Keywords
RESPIRATORY DISORDERLocal subject classification
RHEUMATOID ARTHRITISINTERSTITIAL LUNG DISEASE
MeSH
Arthritis, RheumatoidHumans
Lung Diseases, Interstitial
Pulmonary Fibrosis
Risk Factors
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O'Dwyer, DN et al. Rheumatoid Arthritis (RA) associated interstitial lung disease (ILD). Eur. J. Intern. Med. 2013, 24 (7):597-603Journal
European journal of internal medicineDOI
10.1016/j.ejim.2013.07.004PubMed ID
23916467Abstract
Rheumatoid Arthritis (RA) is the most common Connective Tissue Disease (CTD) and represents an increasing burden on global health resources. Interstitial lung disease (ILD) has been recognised as a complication of RA but its potential for mortality and morbidity has arguably been under appreciated for decades. New studies have underscored a significant lifetime risk of ILD development in RA. Contemporary work has identified an increased risk of mortality associated with the Usual Interstitial Pneumonia (UIP) pattern which shares similarity with the most devastating of the interstitial pulmonary diseases, namely Idiopathic Pulmonary Fibrosis (IPF). In this paper, we discuss recent studies highlighting the associated increase in mortality in RA-UIP. We explore associations between radiological and histopathological features of RA-ILD and the prognostic implications of same. We emphasise the need for translational research in this area given the growing burden of RA-ILD. We highlight the importance of the respiratory physician as a key stakeholder in the multidisciplinary management of this disorder. RA-ILD focused research offers the opportunity to identify early asymptomatic disease and define the natural history of this extra articular manifestation. This may provide a unique opportunity to define key regulatory fibrotic events driving progressive disease. We also discuss some of the more challenging and novel aspects of therapy for RA-ILD.Item Type
ArticleLanguage
enISSN
1879-0828ae974a485f413a2113503eed53cd6c53
10.1016/j.ejim.2013.07.004
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