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类风湿关节炎肺部表现的综述。

Review of pulmonary manifestations of rheumatoid arthritis.

作者信息

Chen Stella, Kay Susannah

机构信息

Department of Radiology, Tufts Medical Center, 800 Washington Street, #299, Boston, MA, 02111, USA.

出版信息

Skeletal Radiol. 2025 May 17. doi: 10.1007/s00256-025-04930-5.

Abstract

Rheumatoid arthritis (RA) is a systemic autoinflammatory disorder that primarily affects joints. However, RA can involve extra-articular structures as well, including the lungs, affecting significant morbidity and mortality, though the precise mechanisms of extra-articular RA are still under investigation. Accurate diagnosis of these conditions can be challenging and requires a multidisciplinary approach. This review aims to describe proposed mechanisms of pulmonary RA and characterize common, clinically relevant pulmonary manifestations of RA, including parenchymal disease (interstitial lung disease and multiple pulmonary nodules), small and large airway involvement, and pleural effusions. In particular, CT imaging may reveal developing pulmonary disease before clinical symptoms present, revealing the importance of maintaining a high degree of suspicion for RA-related pulmonary disease.

摘要

类风湿关节炎(RA)是一种主要影响关节的全身性自身炎症性疾病。然而,RA也可累及关节外结构,包括肺部,这会影响显著的发病率和死亡率,尽管关节外RA的确切机制仍在研究中。准确诊断这些病症具有挑战性,需要多学科方法。本综述旨在描述肺部RA的推测机制,并对RA常见的、临床相关的肺部表现进行特征描述,包括实质疾病(间质性肺疾病和多个肺结节)、大小气道受累以及胸腔积液。特别是,CT成像可能在临床症状出现之前就发现肺部疾病的进展,这表明对RA相关肺部疾病保持高度怀疑的重要性。

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