Radiological features and therapeutic responses of pulmonary nontuberculous mycobacterial disease in rheumatoid arthritis patients receiving biological agents: a retrospective multicenter study in Japan.
Radiological features and therapeutic responses of pulmonary nontuberculous mycobacterial disease in rheumatoid arthritis patients receiving biological agents: a retrospective multicenter study in Japan.
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DOI：
10.1007/s10165-011-0577-6
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发表时间：
2012-09
影响因子：
2.2
通讯作者：
NTM-BIORA (NTM infection in Biologic-treated RA patients) Study Investigators
中科院分区：
文献类型：
--
作者：
Mori S;Tokuda H;Sakai F;Johkoh T;Mimori A;Nishimoto N;Tasaka S;Hatta K;Matsushima H;Kaise S;Kaneko A;Makino S;Minota S;Yamada T;Akagawa S;Kurashima A;NTM-BIORA (NTM infection in Biologic-treated RA patients) Study Investigators
本研究旨在评价类风湿关节炎（RA）生物治疗中非结核分枝杆菌（NTM）所致肺部疾病的影像学特征和治疗反应。我们对来自多个中心的13例在RA生物治疗期间发生肺部NTM疾病的患者进行了回顾性病历审查，包括英夫利昔单抗、依那西普、阿达木单抗和托珠单抗。大多数病例无症状或仅导致普通感冒样症状。计算机断层扫描（CT）成像中的异常是多变的，经常重叠。最主要的模式是结节/支气管扩张疾病（6例），其次是肺泡浸润（3例），空洞疾病（2例）和肺结节（2例）。在大多数情况下，肺部NTM疾病从既存病变扩散;特别是支气管/细支气管异常。在3例病例中，一个或多个结节性病变伴或不伴钙化是病灶。停用生物制剂后，大多数患者对抗NTM治疗有反应。两名患者在没有任何抗NTM治疗的情况下没有恶化。在一名患者中，重新开始托珠单抗治疗，同时继续接受足够的抗NTM治疗产生了有利的结果。在另外两名有肺部NTM疾病病史的患者中，引入生物治疗导致复发，但抗NTM治疗对这些患者有效。在接受生物治疗的RA患者中，肺部NTM疾病的CT异常是可变的，但不是这种临床环境所独有的。NTM疾病可以从预先存在的结构异常传播，即使它们很小。与我们的预期相反，这些患者的肺部NTM疾病的治疗结果是有利的。
This study was performed to evaluate the radiological features of and therapeutic responses to pulmonary disease caused by nontuberculous mycobacteria (NTM) in the setting of biological therapy for rheumatoid arthritis (RA). We conducted a retrospective chart review of 13 patients from multiple centers who had developed pulmonary NTM disease during biological therapy for RA, including infliximab, etanercept, adalimumab, and tocilizumab. Most cases were asymptomatic or resulted in only common-cold-like symptoms. Abnormalities in computed tomography (CT) imaging were protean and frequently overlapped. The most predominant pattern was nodular/bronchiectatic disease (six cases), followed by alveolar infiltrate (three cases), cavitary disease (two cases), and pulmonary nodules (two cases). In most cases, pulmonary NTM disease had spread from a preexisting lesion; in particular, bronchial/bronchiolar abnormalities. In three cases, one or more nodular lesions with or without calcification were a focus of disease. Following the discontinuation of biological agents, most patients responded to anti-NTM therapy. Two patients showed no exacerbation in the absence of any anti-NTM therapy. In one patient, restarting tocilizumab therapy while continuing to receive adequate anti-NTM therapy produced a favorable outcome. In two other patients with a previous history of pulmonary NTM disease, introducing biological therapy led to recurrence, but anti-NTM therapy was effective in these patients. CT abnormalities of pulmonary NTM disease in RA patients receiving biological therapy were variable, but were not unique to this clinical setting. NTM disease can spread from preexisting structural abnormalities, even if they are minute. Contrary to our expectations, the therapeutic outcomes of pulmonary NTM disease were favorable in these patients.
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影响因子：
19.7
作者：
Jeong, YJ;Lee, KS;Kwon, OJ
通讯作者：
Kwon, OJ
影响因子：
4.4
作者：
Taiwo, Babafemi;Glassroth, Jeff
通讯作者：
Glassroth, Jeff
影响因子：
1.2
作者：
Fujita, Kumi;Tanaka, Eisaku;Taguchi, Yoshio
通讯作者：
Taguchi, Yoshio
影响因子：
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作者：
Danko, Janine R.;Gilliland, William R.;Decker, Catherine F.
通讯作者：
Decker, Catherine F.
影响因子：
3.3
作者：
Arend, Sandra M.;van Soolingen, Dick;Ottenhoff, Tom H. M.
通讯作者：
Ottenhoff, Tom H. M.