Medicina clinica · 2026
The utility of lung ultrasound and KL-6 values for the screening of rheumatoid arthritis-associated interstitial lung disease: An exploratory study.
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Casafont-Solé Ivette, Peralta-Garcia Irene, Centeno Carmen, Martínez-Bujidos María, Millán-Billi Paloma, Holgado Susana, Alcubilla Pau, Guasch Ignasi, Portillo Karina
Аннотация
OBJECTIVES: To evaluate the utility of lung ultrasound (LUS) and serum KL-6 levels as screening tools for interstitial lung disease (ILD) in seropositive rheumatoid arthritis (RA) patients, as well as their correlation with ILD extent on high-resolution computed tomography (HRCT).
METHODS: A single-center exploratory study including 20 seropositive RA patients with recent HRCT scans (<2 years) was conducted. Clinical data and pulmonary function tests were recorded. Patients were classified as RA-ILD (n=10) or RA-noILD (n=10). LUS assessed 14 intercostal spaces for B-lines and pleural abnormalities. Serum KL-6 was measured by chemiluminescence immunoassay. HRCT was evaluated by an expert radiologist to quantify ILD extent.
RESULTS: KL-6 levels were higher in RA-ILD patients (p=0.028). More than 10 B-lines per LUS field were exclusively found in RA-ILD (p=0.003), and 5-10 B-lines per field were suggestive of ILD (p=0.002). Pleural thickening was more frequent in RA-ILD (p=0.035). Anterior lung fields were more specifically involved in RA-ILD. B-lines number correlated with ILD extent on HRCT (p=0.001).
CONCLUSIONS: KL-6 and LUS are useful non-invasive screening tools for ILD in seropositive RA patients. A simplified LUS focusing on anterior fields may offer a rapid, reproducible method. Larger prospective studies are needed to establish cut-off values and validate clinical use.
METHODS: A single-center exploratory study including 20 seropositive RA patients with recent HRCT scans (<2 years) was conducted. Clinical data and pulmonary function tests were recorded. Patients were classified as RA-ILD (n=10) or RA-noILD (n=10). LUS assessed 14 intercostal spaces for B-lines and pleural abnormalities. Serum KL-6 was measured by chemiluminescence immunoassay. HRCT was evaluated by an expert radiologist to quantify ILD extent.
RESULTS: KL-6 levels were higher in RA-ILD patients (p=0.028). More than 10 B-lines per LUS field were exclusively found in RA-ILD (p=0.003), and 5-10 B-lines per field were suggestive of ILD (p=0.002). Pleural thickening was more frequent in RA-ILD (p=0.035). Anterior lung fields were more specifically involved in RA-ILD. B-lines number correlated with ILD extent on HRCT (p=0.001).
CONCLUSIONS: KL-6 and LUS are useful non-invasive screening tools for ILD in seropositive RA patients. A simplified LUS focusing on anterior fields may offer a rapid, reproducible method. Larger prospective studies are needed to establish cut-off values and validate clinical use.