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Arthritis und Rheuma 2022; 42(05): 324-329
DOI: 10.1055/a-1893-4857
Schwerpunkt

Interstitielle Lungenbeteiligung bei der rheumatoiden Arthritis

Interstitial lung disease in rheumatoid arthritis
Philipp Klemm
1   Justus-Liebig University Gießen, Campus Kerckhoff, Abteilung für Rheumatologie, klinische Immunologie, Osteologie und Physikalische Medizin, Bad Nauheim
,
Jörg Henes
2   Zentrum für Interdisziplinäre Klinische Immunologie, Rheumatologie und Autoimmunerkrankungen und Abteilung II des Departments für Innere Medizin, Universitätsklinikum Tübingen, Tübingen
,
Panagiota Xanthouli
3   Sektion für Pulmonale Hypertonie, Thoraxklinik am Universitätsklinikum Heidelberg; Innere Medizin V Hämatologie/Onkologie/Rheumatologie, Universitätsklinikum Heidelberg
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ZUSAMMENFASSUNG

Die RA-ILD ist eine schwerwiegende extraartikuläre Manifestation der RA, welche mit einer gesteigerten Mortalität einhergeht. Dieser Beitrag verschafft einen Überblick und greift neue Erkenntnisse zu diesem wichtigen Thema auf. Eingegangen wird auf Epidemiologie, Risikofaktoren, Prognose sowie auf Diagnostik und Therapie. Besonders wichtig sind die frühe Diagnose und die Evaluation der Risikofaktoren. Diese ermöglichen eine Prognoseabschätzung. Dabei spielt die HRCT-Morphologie der Lungen wie auch eine Mutation in MUC5B eine besondere Rolle. In der täglichen Praxis sollte Augenmerk auf Anamnese, körperliche Untersuchung und die regelmäßige Lungenfunktion gerichtet werden, um progredient fibrosierende Verläufe der RA-ILD frühzeitig zu entdecken. Für diese Verlaufsformen gibt es neben der Therapie mittlerweile auch die Option einer antifibrotischen Therapie.

ABSTRACT

RA-ILD is an important extra-articular manifestation of RA and associated with increased mortality. This article provides an overview and reviews recent findings. Epidemiology, risk factors, prognosis as well as diagnostics and therapy are addressed. Early diagnosis and evaluation of risk factors are particularly important. These allow prognosis estimation. Attention should be paid to HRCT morphology of the lungs and to mutation in MUC5B. In daily practice patient history, physical examination and regular pulmonary function testing to detect progressive fibrosing courses of RA-ILD early on are crucial. For progressive fibrosing RA-ILD, there is now the option of antifibrotic therapy in addition to immunomodulatory therapy.

Schlüsselwörter

Rheumatoide Arthritis - Lunge - Lungenfibrose - Therapie

Keywords

Rheumatoid arthritis - lung - fibrosis - therapy


Publication History

Article published online:
05 November 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
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