The role of lung ultrasound B-lines and serum KL-6 in the screening and follow-up of rheumatoid arthritis patients for an identification of interstitial lung disease: review of the literature, proposal for a preliminary algorithm, and clinical application to cases
| Autor: | Kedi Zheng, Shijian Hu, Marco Matucci-Cerinic, Qisheng Lin, Jinghua Zhuang, Shaoyu Zheng, Anna-Maria Hoffmann-Vold, Weijin Zhang, Daniel E. Furst, Guangzhou Du, Yukai Wang, Jianqun Lin, Shaoqi Chen, Guohong Zhang, Xuezhen Xie |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
High-resolution computed tomography Rheumatoid arthritis–associated interstitial lung disease Review Diseases of the musculoskeletal system Asymptomatic behavioral disciplines and activities Pulmonary function testing Arthritis Rheumatoid B-lines Usual interstitial pneumonia Internal medicine medicine Humans Lung Pathological Pulmonary function tests Lung ultrasound medicine.diagnostic_test business.industry Mucin-1 KL-6 Interstitial lung disease Follow up respiratory system medicine.disease Rheumatology respiratory tract diseases RC925-935 Screen Rheumatoid arthritis medicine.symptom Lung Diseases Interstitial business Algorithm Algorithms Follow-Up Studies |
| Zdroj: | Arthritis Research & Therapy, Vol 23, Iss 1, Pp 1-10 (2021) Arthritis Research & Therapy |
| ISSN: | 1478-6362 |
| Popis: | Screening and follow-up of interstitial lung disease associated with rheumatoid arthritis (RA-ILD) is a challenge in clinical practice. In fact, the majority of RA-ILD patients are asymptomatic and optimal tools for early screening and regular follow-up are lacking. Furthermore, some patients may remain oligosymptomatic despite significant radiological abnormalities. In RA-ILD, usual interstitial pneumonia (UIP) is the most frequent radiological and pathological pattern, associated with a poor prognosis and a high risk to develop acute exacerbations and infections. If RA-ILD can be identified early, there may be an opportunity for an early treatment and close follow-up that might delay ILD progression and improve the long-term outcome.In connective tissue disease–associated interstitial lung disease (CTD-ILD), lung ultrasound (LUS) with the assessment of B-lines and serum Krebs von den Lungen-6 antigen (KL-6) has been recognized as sensitive biomarkers for the early detection of ILD. B-line number and serum KL-6 level were found to correlate with high-resolution computed tomography (HRCT), pulmonary function tests (PFTs), and other clinical parameters in systemic sclerosis–associated ILD (SSc-ILD). Recently, the significant correlation between B-lines and KL-6, two non-ionizing and non-invasive biomarkers, was demonstrated. Hence, the combined use of LUS and KL-6 to screen and follow up ILD in RA patients might be useful in clinical practice in addition to existing tools. Herein, we review relevant literature to support this concept, propose a preliminary screening algorithm, and present 2 cases where the algorithm was used. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink