Abstract

Background: Interstitial lung disease (ILD) is the most common manifestation of lung lesions in patients with rheumatoid arthritis (RA). In Vietnam, currently the treatment of RA is still a challenge in clinical practice. Besides, the detection, treatment and management of interstitial lung disease in RA patients is still controversial among clinicians. So we conducted this study. Methods: Prospective study describing all RA patients with interstitial lung disease diagnosed, treated and monitored at the Department of Internal Medicine and Rheumatology at Gia Dinh Hospital during the period from February 2023 to February 2024. We enrolled 233 patients with rheumatoid arthritis, including 91 patients diagnosed with ILD by high-resolution chest CT according to ATS/ERS/JRS/ALAT 2018 standards. Results: Females accounted for 90.1%, the male:female ratio was 1:9. The average age of the patient group is 59.6 years old, the group of patients over 50 years old accounts 85.8%. 1/3 of patients have rheumatoid arthritis for 5 years or more. Regarding clinical respiratory characteristics, we found that the majority of patients had symptoms of difficulty breathing, accounting for 68.1%. Most patients have mild dyspnea with mMRC score level 1, accounting for 52.7%. The SDAI scale shows that most patients have a high level of activity. On high-resolution chest CT, images of parenchymal lesions in the form of common interstitial pneumonia (UIP) account for the highest proportion of 70.4%, and atypical interstitial pneumonia accounts for 26.3%. Most of the area of lung parenchymal damage accounts for 5% (ratio is 65.9%). Pulmonary fibrosis is detected in more than half of patients. Conclusion: Patients with rheumatoid arthritis need to be screened for interstitial lung disease when they have the following factors: being 50 years old or older, having respiratory symptoms such as difficulty breathing, dry cough. RA disease duration > 5 years. Most patients have UIP-type lung damage on high-resolution chest CT images and attention should be paid to pulmonary fibrosis associated with ILD