Obliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case series
Abstract Background Rheumatoid arthritis (RA) is a systemic autoimmune condition characterized by erosive inflammation of the joints. One rare pulmonary manifestation is obliterative bronchiolitis (OB), a small airways disease characterized by the destruction of bronchiolar epithelium and airflow ob...
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doaj-19ab2e829df74716bd8c6496ad1f4b0e2020-11-24T21:15:54ZengBMCBMC Pulmonary Medicine1471-24662018-06-011811710.1186/s12890-018-0673-xObliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case seriesErica Lin0Andrew H. Limper1Teng Moua2Department of Internal MedicineDivision of Pulmonary and Critical Care Medicine, Mayo ClinicDivision of Pulmonary and Critical Care Medicine, Mayo ClinicAbstract Background Rheumatoid arthritis (RA) is a systemic autoimmune condition characterized by erosive inflammation of the joints. One rare pulmonary manifestation is obliterative bronchiolitis (OB), a small airways disease characterized by the destruction of bronchiolar epithelium and airflow obstruction. Methods We retrospectively reviewed the clinical data of patients with rheumatoid arthritis-associated obliterative bronchiolitis (RA-OB) from 01/01/2000 to 12/31/2015. Presenting clinical features, longitudinal pulmonary function testing, radiologic findings, and independent predictors of all-cause mortality were assessed. Results Forty one patients fulfilled criteria for diagnosis of RA-OB. There was notable female predominance (92.7%) with a mean age of 57 ± 15 years. Dyspnea was the most common presenting clinical symptom. Median FEV1 was 40% (IQR 31–52.5) at presentation, with a mean decline of − 1.5% over a follow-up period of thirty-three months. Associated radiologic findings included mosaic attenuation and pulmonary nodules. A majority of patients (78%) received directed therapy including long-acting inhalers, systemic corticosteroids or other immunosuppressive agents, and macrolide antibiotics. All-cause mortality was 27% over a median follow-up of sixty-two months (IQR 32–113). No distinguishable predictors of survival at presentation were found. Conclusions RA-OB appears to have a stable clinical course in the majority of patients despite persistent symptoms and severe obstruction based on presenting FEV1.http://link.springer.com/article/10.1186/s12890-018-0673-xRheumatoid arthritisObliterative bronchiolitisSmall airways disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Erica Lin Andrew H. Limper Teng Moua |
spellingShingle |
Erica Lin Andrew H. Limper Teng Moua Obliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case series BMC Pulmonary Medicine Rheumatoid arthritis Obliterative bronchiolitis Small airways disease |
author_facet |
Erica Lin Andrew H. Limper Teng Moua |
author_sort |
Erica Lin |
title |
Obliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case series |
title_short |
Obliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case series |
title_full |
Obliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case series |
title_fullStr |
Obliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case series |
title_full_unstemmed |
Obliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case series |
title_sort |
obliterative bronchiolitis associated with rheumatoid arthritis: analysis of a single-center case series |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2018-06-01 |
description |
Abstract Background Rheumatoid arthritis (RA) is a systemic autoimmune condition characterized by erosive inflammation of the joints. One rare pulmonary manifestation is obliterative bronchiolitis (OB), a small airways disease characterized by the destruction of bronchiolar epithelium and airflow obstruction. Methods We retrospectively reviewed the clinical data of patients with rheumatoid arthritis-associated obliterative bronchiolitis (RA-OB) from 01/01/2000 to 12/31/2015. Presenting clinical features, longitudinal pulmonary function testing, radiologic findings, and independent predictors of all-cause mortality were assessed. Results Forty one patients fulfilled criteria for diagnosis of RA-OB. There was notable female predominance (92.7%) with a mean age of 57 ± 15 years. Dyspnea was the most common presenting clinical symptom. Median FEV1 was 40% (IQR 31–52.5) at presentation, with a mean decline of − 1.5% over a follow-up period of thirty-three months. Associated radiologic findings included mosaic attenuation and pulmonary nodules. A majority of patients (78%) received directed therapy including long-acting inhalers, systemic corticosteroids or other immunosuppressive agents, and macrolide antibiotics. All-cause mortality was 27% over a median follow-up of sixty-two months (IQR 32–113). No distinguishable predictors of survival at presentation were found. Conclusions RA-OB appears to have a stable clinical course in the majority of patients despite persistent symptoms and severe obstruction based on presenting FEV1. |
topic |
Rheumatoid arthritis Obliterative bronchiolitis Small airways disease |
url |
http://link.springer.com/article/10.1186/s12890-018-0673-x |
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