• Aryeh Fischer, Joshua J Solomon, Roland M du Bois, Kevin D Deane, Amy L Olson, Evans R Fernandez-Perez, Tristan J Huie, Allen D Stevens, Mary B Gill, Avi M Rabinovitch, David A Lynch, David A Burns, Isabel S Pineiro, Steve D Groshong, Rosane D Duarte Achcar, Kevin K Brown, Richard J Martin, and Jeffrey J Swigris.
• Autoimmune Lung Center, National Jewish Health, Denver, CO 80206, USA. fischera@njhealth.org
• Respir Med. 2012 Jul 1; 106 (7): 1040-7.

ObjectiveWe sought to characterize a novel cohort of patients with lung disease, anti-cyclic citrullinated peptide (CCP) antibody positivity, without rheumatoid arthritis (RA) or other connective tissue disease (CTD).MethodsThe study sample included 74 subjects with respiratory symptoms, evaluated January 2008-January 2010 and found to have a positive anti-CCP antibody but no evidence for RA or other CTD. Each underwent serologic testing, pulmonary physiology testing, and thoracic high-resolution computed tomography (HRCT) scan as part of routine clinical evaluation.ResultsThe majority of subjects were women, and most were former cigarette smokers. Four distinct radiographic phenotypes were identified: isolated airways disease (54%), isolated interstitial lung disease (ILD) (14%), mixed airways disease and ILD (26%), and combined pulmonary fibrosis with emphysema (7%). This cohort had a predominance of airways disease, either in isolation or along with a usual interstitial pneumonia-pattern of ILD. Among subjects with high-titer anti-CCP positivity (n=33), three developed the articular manifestations of RA during a median follow-up of 449 days.ConclusionWe have described a unique cohort of patients with anti-CCP antibody positivity and lung disease in the absence of existing RA or other CTD. The lung phenotypic characteristics of this cohort resemble those of established RA and a few of these patients have developed articular RA within a short period of follow-up. The implications of a positive anti-CCP antibody among patients with lung disease but not RA are not yet known, but we believe requires further investigation.Copyright © 2012 Elsevier Ltd. All rights reserved.

33 keywords...

hide…