POS1076\u2005APICAL FIBROSIS AND INTERSTITIAL LUNG DISEASE IN PATIENTS WITH PSORIATIC ARTHRITIS: DO WE UNDERESTIMATE?

Abstract

Extra-articular manifestation (EAMs) definition is not clearly defined in psoriatic arthritis (PsA). Nail involvement, enthesitis, dactylitis has been widely studied however, data are needed on pulmonary involvement in PsA.We aimed to understand real-life results of lung involvement in PsA patients.From the PsA cohort followed in our outpatient clinic, patients who have been requested a chest computed tomography (CT) for any reason by any department were retrieved from medical records and included in this retrospective cross-sectional analysis. All CTs were assessed by a radiologist who is blinded to the patients` clinical history and findings were categorized as parenchymal, airway, pleural findings and lymphadenopathy (LAM). Moreover, any findings that are radiologically attributed to a specific entity such as previous tuberculosis (Tb) infection were noted. Demographic/clinic data including smoking status, concomitant lung problems, disease characteristics (duration, axial/ peripheral involvement) were collected and analyzed.A total of 80/1072 (7.4 %; 65% female) PsA patients with mean (SD) age 56.1 (13.2) years were included in the study. Median (IQR) PsA duration was 23.5 (55.75) months and 36 (45%) patients had peripheral, 29 (36.3%) patients had axial involvement. For the rest of 15 (18.7 %) patients, radiographic assessment was missing. Smoking status could be retrieved in 47 patients (never=40.4%, ex-smoker= 19.1%, current smoker=40.4%). There were 14 concomitant lung problem in 12 (15%) patients. CT findings showed that 68.8% of patients had at least one lung pathology. Parenchymal findings were seen in 65% of the patients as both non-spesific changes (atelectasis, n= 35; nodules, n=24; ground glass opacity, n= 9; sequelae fibrosis, n= 9; emphysema, n= 7; consolidation, n= 5, interstitial thickening, n= 5; pulmonary cyst, n =4) and specific pathologies as apical fibrosis (AF) (n=5) and intersititial lung disease (ILD) (n=5, NSIP=3, LIP=2). AF was linked to previous Tb infection in 1 patient and radiotherapy in another (Table 1). However, there is no specific pathology in the rest of 3 (3.7%) patients that AF could be attributed to and all of them were male. Other pathologies were seen as airway findings in 28.8% patients (bronchiectasis, n= 17, bronchial wall thickness, n= 10, air trapping n= 7, centrilobular opacity, n= 4,) and pleural findings in 13.8 % of the patients (pleural plaque, n= 5, effusion, n= 3, thickness, n=3). LAM was observed in around 4% of the patients.Table 1.Patient characteristics with apical fibrosis, interstitial lung diseaseInvolvementGenderAgePsA duration, monthsAxialDisease(yes/no)SmokingStatusSmoking package-yearsConcomitantLung Disease(yes/no)Linked toanother problemby radiologist(yes/no)ID-1AFM582NoCurrent40NoNoID-2AFM611NoCurrent40NoNoID-3AFM73122YesEx30NoNoID-4AFF551YesNANANoYes*ID-5AFF65#NANever-Yes€Yes€ID-6NSIPF96NANANever-NoNoID-7NSIPM69NANAEx15Yes$NoID-8NSIPF66156NoNANAYes$NoID-9LIPM61200YesNever-NoNoID-10LIPF8014YesNANANoNoAF= Apical fibrosis; NSIP= Non-spesific interstitial pneumonia, LIP= Lymphocytic interstitial pneumonia; PsA= Psoriatic Arthritis, NA= Not available*radiotherapy sequelae; # tomography was done prior to PsA diagnosis; € previous tuberculosis infection; $ chronic obstructive pulmonary diseaseThe real-life experience of our PsA cohort showed that pulmonary findings included variable spesific, non-spesific findings. As a limitation results represent the CT findings of around 8% of our PsA cohort. Within the scope of previous reports male predominant AF and ILD come forward in PsA that requires further attention in future studies [1,2].[1]Peluso R, Iervolino S, Vitiello M, et al (2015) Extra-articular manifestations in psoriatic arthritis patients. Clin Rheumatol 34 (4):745-753.[2]Bargagli E, Bellisai F, Mazzei MA, et al (2020) Interstitial lung disease associated with psoriatic arthritis: a new disease entity? Intern Emerg Med.None declared.