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Respir Med. 2012 Jul;106(7):1040-7. doi: 10.1016/j.rmed.2012.03.006. Epub 2012 Apr 12.

Lung disease with anti-CCP antibodies but not rheumatoid arthritis or connective tissue disease.

Author information

1
Autoimmune Lung Center, National Jewish Health, Denver, CO 80206, USA. fischera@njhealth.org

Abstract

OBJECTIVE:

We 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).

METHODS:

The 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.

RESULTS:

The 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.

CONCLUSION:

We 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.

PMID:
22503074
PMCID:
PMC3753791
DOI:
10.1016/j.rmed.2012.03.006
[Indexed for MEDLINE]
Free PMC Article
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