RESEARCH - RA-specific anutoantibodies in patients with interstitial lung diesase and absence of clinically apparent articular RA

[Guest guest]

Clin Rheumatol. 2009 May;28(5):611-3. Epub 2009 Feb 28.

Rheumatoid arthritis (RA)-specific autoantibodies in patients with

interstitial lung disease and absence of clinically apparent articular

RA.

Gizinski AM, Mascolo M, Loucks JL, Kervitsky A, Meehan RT, Brown KK,

Holers VM, Deane KD.

Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA.

The purpose of this study was to identify rheumatoid arthritis

(RA)-related autoantibodies in subjects with interstitial lung disease

(ILD) and no articular findings of RA, supporting the hypothesis that

RA-related autoimmunity may be generated in non-articular sites, such

as the lung. This was a retrospective chart review utilizing clinic

databases of patients with ILD to identify cases with lung disease,

RA-related autoantibody positivity, and no clinical evidence of

articular RA. Four patients with ILD, RF, and anti-CCP positivity and

no articular findings of RA were identified. All four patients were

male with a mean age at time of diagnosis of ILD of 70 years old. All

had a history of smoking. Three patients died within 2 years of

diagnosis of ILD and never developed articular symptoms consistent

with RA; the final case met full criteria for articular RA several

months after stopping immunosuppressive treatment for ILD. RF and

anti-CCP can be present in smokers with ILD without clinical evidence

of articular RA and in one case symptomatic ILD and autoantibody

positivity preceded the development of articular RA. These findings

suggest that RA-specific autoimmunity may be generated due to

immunologic interactions in the lung and may be related to

environmental factors such as smoking.

PMID: 19252818

http://www.ncbi.nlm.nih.gov/pubmed/19252818

Not an MD