Blanco Pérez JJ, Arnalich Montiel V, Salgado-Barreira Á, Alvarez Moure MA, Caldera Díaz AC, Melero Gonzalez R, Pallarés Sanmartín A, Fernandez Villar A, González Barcala FJ. Prevalence and Clinical Impact of Systemic Autoimmune Rheumatic Disease in Patients with Silicosis.
Arch Bronconeumol 2020;
57:S0300-2896(20)30129-0. [PMID:
32493645 DOI:
10.1016/j.arbres.2020.04.012]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND
Silicosis is associated with an increased risk of developing systemic autoimmune rheumatic disease (SARD). The prognostic implications of this association are poorly characterized. The aim of this study was to determine the prevalence of SARD and autoimmune markers in a cohort of patients with exposure to silica and assess their impact on prognosis.
METHOD
We performed a prospective observational study of all patients attending the dedicated silicosis clinic of our pulmonology unit between 2009 and December 2017. Diagnosis was confirmed by a rheumatologist according to Spanish Rheumatology Society criteria. Autoimmune markers, pulmonary function tests, radiological progression, visits to the emergency department and primary care center, and hospital admissions for respiratory causes, and mortality were analyzed.
RESULTS
Overall, 489 cases of silicosis and 95 cases of exposure were studied. In total, 54 (11.0%) patients with silicosis had SARD: 12 (2.4%) rheumatoid arthritis, 10 (2.0%) systemic lupus erythematosus, 10 (2.0%) systemic sclerosis, 3 (0.6%) Sjögren syndrome, 2 (0.4%) vasculitis associated with anti-neutrophil cytoplasmic antibodies (ANCA +), 6 (1.2%) psoriatic arthritis, 3 (0.6%) ankylosing spondylitis, and 8 (1.6%) other autoimmune diseases with no special features. The patients with SARD visited the emergency room more often (63.0 vs. 42.5%; p = 0.004), and progressed more rapidly (22.2 vs. 11.7%; p = 0.030).
CONCLUSIONS
The presence of systemic rheumatic autoimmune diseases involves radiological progression and a higher clinical impact.
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