Bendstrup Elisabeth, Møller Janne, Kronborg-White Sissel, Prior Thomas Skovhus, Hyldgaard Charlotte
Center for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark.
.Regional Hospital, Falkevej 1-3, 8600 Silkeborg, Denmark.
J Clin Med. 2019 Nov 21;8(12):2038. doi: 10.3390/jcm8122038.
Interstitial lung disease (ILD) is a serious complication of rheumatoid arthritis (RA) contributing to significantly increased morbidity and mortality. Other respiratory complications, such as chronic obstructive pulmonary disease and bronchiectasis, are frequent in RA. Infections and drug toxicity are important differential diagnoses and should be considered in the diagnostic work-up of patients with RA presenting with respiratory symptoms. This review provides an overview of the epidemiology and pathogenesis of RA-ILD, the radiological and histopathological characteristics of the disease as well as the current and future treatment options. Currently, there is no available evidence-based therapy for RA-ILD, and immunosuppressants are the mainstay of therapy. Ongoing studies are exploring the role of antifibrotic therapy in patients with progressive fibrotic ILD, which may lead to a new treatment approach for subgroups of patients with RA-ILD.
间质性肺疾病（ILD）是类风湿关节炎（RA）的一种严重并发症，会导致发病率和死亡率显著增加。其他呼吸系统并发症，如慢性阻塞性肺疾病和支气管扩张，在RA中很常见。感染和药物毒性是重要的鉴别诊断因素，在对出现呼吸道症状的RA患者进行诊断检查时应予以考虑。本综述概述了RA-ILD的流行病学和发病机制、该疾病的放射学和组织病理学特征以及当前和未来的治疗选择。目前，尚无针对RA-ILD的循证疗法，免疫抑制剂是主要治疗手段。正在进行的研究正在探索抗纤维化疗法在进行性纤维化ILD患者中的作用，这可能会为RA-ILD患者亚组带来新的治疗方法。
