Department of Rheumatology, Beijing Chao-yang Hospital, Capital Medical University, #8 Gong-Ti South Road, Chaoyang District, Beijing, 100020, China.
Department of Radiology, Beijing Chao-yang Hospital, Beijing, China.
Clin Rheumatol. 2018 Apr;37(4):1027-1035. doi: 10.1007/s10067-017-3694-6. Epub 2017 Jul 26.
To study the clinical characteristics of autoimmune rheumatic disease-related organizing pneumonia (AIRD-OP), the clinical presentation, radiological findings, treatment, and outcome of AIRD-OP patients were analyzed, in comparison with patients with cryptogenic organizing pneumonia (COP). A total of 131 OP patients were identified, including 57 cases of AIRD-OP, 35 cases of COP, and 39 cases of other disease-related OPs. Among AIRD-OP patients, 36 (63%) presented the symptoms of OP at onset. The primary disease of AIRDs included Sjogren's syndrome (38%), polymyositis/dermatomyositis (23%), rheumatoid arthritis (23%), and undifferentiated AIRD. Compared with COP patients, the prevalence of patients having cough and malaise at baseline was significantly lower (54.4 vs 82.9%, P < 0.05; 49.1 vs 70.6%, P < 0.05), and the signs of moist rales and crackles were more common in AIRD-OP patients (54.4 vs 32.4%, P < 0.05; 49.1 vs 26.5%, P < 0.05). Lung function (TLC%, FVC%) was more significantly reduced in AIRD-OP patients (72 vs 97%, P < 0.05;75 vs 96%, P < 0.05). The dosage of corticosteroids prescribed was significantly higher in AIRD-OP patients (44 vs 37 mg/day, P < 0.05). The complete recovery rate was slightly lower in AIRD-OP patients (22.2 vs 29%, P > 0.05) with a tendency towards higher recurrence rate in AIRD-OP patients (32.7 vs 14.3%, P < 0.05). AIRD-OP may be the most common cause of OP. OP can be the initial presentation of AIRD. Compared with COP patients, AIRD-OP patients are characterized with occult onset but more severe lung involvement and higher recurrence rate.
为研究自身免疫性风湿病相关机化性肺炎(AIRD-OP)的临床特征,分析了 AIRD-OP 患者的临床表现、影像学表现、治疗和结局,并与隐源性机化性肺炎(COP)患者进行了比较。共确定了 131 例 OP 患者,其中 57 例为 AIRD-OP,35 例为 COP,39 例为其他疾病相关 OP。在 AIRD-OP 患者中,36 例(63%)在发病时出现 OP 症状。AIRD 包括干燥综合征(38%)、多发性肌炎/皮肌炎(23%)、类风湿关节炎(23%)和未分化的 AIRD。与 COP 患者相比,基线时咳嗽和不适的患者比例明显较低(54.4%比 82.9%,P<0.05;49.1%比 70.6%,P<0.05),AIRD-OP 患者肺部湿啰音和爆裂音更为常见(54.4%比 32.4%,P<0.05;49.1%比 26.5%,P<0.05)。AIRD-OP 患者的肺功能(TLC%,FVC%)明显降低(72%比 97%,P<0.05;75%比 96%,P<0.05)。AIRD-OP 患者的皮质激素剂量明显较高(44 比 37mg/天,P<0.05)。AIRD-OP 患者完全缓解率略低(22.2%比 29%,P>0.05),但复发率较高(32.7%比 14.3%,P<0.05)。AIRD-OP 可能是 OP 最常见的原因。OP 可能是 AIRD 的首发表现。与 COP 患者相比,AIRD-OP 患者的特点是隐匿性发病,但肺部受累更严重,复发率更高。