Isabel M McFarlane1,2, Su Yien Zhaz3,4, Manjeet S Bhamra3,5, Aaliya Burza3,6, Srinivas Kolla3,7, Milena Rodriguez Alvarez3,5, Kristaq Koci3,5, Nicholas Taklalsingh3,5, Joshy Pathiparampil3,5, Latoya Freeman3,5, Ian Kaplan3,5, Naureen Kabani3,5, David J Ozeri3,8, Elsie Watler3,5, Mosab Frefer3,5, Vytas Vaitkus3,5, Keron Matthew3,5, Fray Arroyo-Mercado3,5, Helen Lyo3,5, Tomasz Zrodlowski3,5, Aleksander Feoktistov3,5, Randolph Sanchez3,9, Cristina Sorrento3,5, Faisal Soliman3,10, Felix Reyes Valdez3,11, Veena Dronamraju3,5, Michael Trevisonno3,5, Christon Grant3,5, Guerrier Clerger3,5, Khabbab Amin3,5, Makeda Dawkins3,5, Jason Green3,5, Jane Moon3,5, Samir Fahmy3,6, Stephen Anthony Waite3,7. 1. Department of Internal Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care and Division of Radiology, State University of New York Downstate Medical Center and New York City Health & Hospitals Kings County, Brooklyn, NY, 11203, USA. Isabel.McFarlane@downstate.edu. 2. Department of Internal Medicine, Division of Rheumatology, SUNY-Downstate Medical Center, Health & Hospitals Kings County, Brooklyn, NY, 11201, USA. Isabel.McFarlane@downstate.edu. 3. Department of Internal Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care and Division of Radiology, State University of New York Downstate Medical Center and New York City Health & Hospitals Kings County, Brooklyn, NY, 11203, USA. 4. Samaritan Medical Center Department of Rheumatology, Watertown, NY, 13601, USA. 5. Department of Internal Medicine, Division of Rheumatology, SUNY-Downstate Medical Center, Health & Hospitals Kings County, Brooklyn, NY, 11201, USA. 6. Department of Medicine, Division of Pulmonary and Critical Care State, SUNY Downstate Medical Center, Health & Hospitals Kings County, Brooklyn, NY, 11201, USA. 7. Department of Radiology, SUNY Downstate Medical Center, Health & Hospitals Kings County, Brooklyn, NY, 11201, USA. 8. Sheba Medical Center, 6100000, Tel Aviv, Israel. 9. Department of Rheumatology, Hahnemann Hospital, Philadelphia, PA, 19019, USA. 10. Department of Geriatrics, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, 11201, USA. 11. Department of Family and Social Medicine, Montefiore Medical Center Albert Einstein College of Medicine, Bronx, NY, 10468, USA.
Abstract
BACKGROUND: Conflicting reports exist regarding the racial and the gender distribution of rheumatoid arthritis-related interstitial lung disease (RA-ILD). In a major population study of predominately Whites, RA-ILD was reported mainly among smoker middle-aged men. However, recent data suggest that the disease is that of elderly women. Our study aimed to assess the prevalence and identify the gender differences and clinical characteristics of RA-ILD in a predominantly Black population. METHODS: Cross-sectional analysis of data obtained from the records of 1142 patients with RA diagnosis by ICD codes of which 503 cases met the inclusion criteria for the study. Eighty-six patients had chronic respiratory symptoms of cough and dyspnea and were further assessed by our multidisciplinary group of investigators. Thirty-two subjects with an established diagnosis of rheumatoid arthritis met the diagnostic criteria for interstitial lung disease. RESULTS: Of the 32 patients with RA-ILD, mean age was 62.6 ± 2.2 (± SEM), 93.7% were females, and 89% Blacks with a BMI = 29.2 (Kg/m2). Usual interstitial pneumonia (UIP) was found in 24/32 (75%) of the cases. Seventy-two percent of the RA-ILD patient had seropositive RA. Smoking history was reported in 31.3% of the cohort, gastroesophageal reflux disease (GERD) in 32.3%, and cardiovascular disease (CVD) risk factors in 65.6%. CONCLUSION: Our study indicates RA-ILD among Blacks is predominantly a disease of elderly females with higher rates of GERD and CVD risk factors. Further studies are needed to identify the pathogenetic differences accounting for the gender distribution of RA-ILD among Black and White populations.Key Points• First study to assess ILD among predominantly Black RA patients.• The prevalence of RA-associated ILD was 6.36%, affecting mostly women in their sixth decade with seropositive disease.• COPD was the most common airway disease among non-RA-ILD Black population.• GERD was found in approximately one-third of patients with RA-associated ILD versus one-fifth of those RA patients without any lung disease.
BACKGROUND: Conflicting reports exist regarding the racial and the gender distribution of rheumatoid arthritis-related interstitial lung disease (RA-ILD). In a major population study of predominately Whites, RA-ILD was reported mainly among smoker middle-aged men. However, recent data suggest that the disease is that of elderly women. Our study aimed to assess the prevalence and identify the gender differences and clinical characteristics of RA-ILD in a predominantly Black population. METHODS: Cross-sectional analysis of data obtained from the records of 1142 patients with RA diagnosis by ICD codes of which 503 cases met the inclusion criteria for the study. Eighty-six patients had chronic respiratory symptoms of cough and dyspnea and were further assessed by our multidisciplinary group of investigators. Thirty-two subjects with an established diagnosis of rheumatoid arthritis met the diagnostic criteria for interstitial lung disease. RESULTS: Of the 32 patients with RA-ILD, mean age was 62.6 ± 2.2 (± SEM), 93.7% were females, and 89% Blacks with a BMI = 29.2 (Kg/m2). Usual interstitial pneumonia (UIP) was found in 24/32 (75%) of the cases. Seventy-two percent of the RA-ILDpatient had seropositive RA. Smoking history was reported in 31.3% of the cohort, gastroesophageal reflux disease (GERD) in 32.3%, and cardiovascular disease (CVD) risk factors in 65.6%. CONCLUSION: Our study indicates RA-ILD among Blacks is predominantly a disease of elderly females with higher rates of GERD and CVD risk factors. Further studies are needed to identify the pathogenetic differences accounting for the gender distribution of RA-ILD among Black and White populations.Key Points• First study to assess ILD among predominantly Black RApatients.• The prevalence of RA-associated ILD was 6.36%, affecting mostly women in their sixth decade with seropositive disease.• COPD was the most common airway disease among non-RA-ILD Black population.• GERD was found in approximately one-third of patients with RA-associated ILD versus one-fifth of those RApatients without any lung disease.
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Authors: Kurnvir Singh; Mohammed Al-Sadawi; Romy Rodriguez Ortega; Khaleda Akter; Tomasz Zrodlowski; Claudia Zmijewski; Isabel M McFarlane Journal: Am J Med Case Rep Date: 2019-10-28