Low body mass index and lymphocytopenia associate with Mycobacterium avium complex pulmonary disease in patients with rheumatoid arthritis |
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Authors: | Wataru Hirose Masayoshi Harigai Takashi Uchiyama Kenji Itoh Toshiaki Ishizuka Mitsuyo Matsumoto |
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Institution: | 1. Hirose Clinic of Rheumatology, Saitama, Japan;2. Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan;3. Division of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Society, Tokyo, Japan;4. Department of Internal Medicine, Division of Rheumatology, National Defense Medical College, Saitama, Japan;5. Department of Pharmacology, National Defense Medical College, Saitama, Japan |
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Abstract: | Objectives: Patients with rheumatoid arthritis (RA) are at an increased risk of Mycobacterium avium complex pulmonary disease (MAC-PD). We aimed to identify factors associated with MAC-PD in RA patients, and investigate their clinical significance for diagnosis of this disease.Methods: We examined 396 patients with RA for the presence of MAC-PD, using the criteria of the American Thoracic Society and conducted three years of follow-up on these patients. Multivariate logistic analyses were employed for selecting factors associated with MAC-PD. We developed a point system based on these factors which we call MAC-PD score to improve diagnosis of MAC-PD.Results: During this study, 14 out of 396 patients were newly diagnosed with MAC-PD. Multivariate analyses revealed body mass index (BMI)?<18.0?kg/m2 and lymphocyte count <1500/μl were associated with MAC-PD in RA patients. Points were assigned to them and totalled to provide the MAC-PD score. Among 20 patients with high-resolution computer tomography images consistent with MAC-PD, the scores were significantly higher in 14 patients with MAC-PD than those in six patients without MAC-PD.Conclusion: Using these data, in the forms of the MAC-PD score, could help to identify patients who should be considered for bronchoscopy more selectively. |
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Keywords: | Rheumatoid arthritis Mycobacterium avium complex pulmonary disease lymphocytopenia low BMI |
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