Drs. Mori and Cho reply

Abstract

We thank Dr. Georgiadis and colleagues for their comments on our study1. We are pleased that our findings have attracted the interest of readers, and we offer the following response. First, Georgiadis, et al state that we reported no significant differences in HRCT findings between patients with early RA and those with longstanding RA, but we think that this is a misinterpretation. We performed HRCT on a total of 126 patients with either early RA (n = 65) or longstanding RA (n = 61). Abnormalities on HRCT imaging were categorized, and the frequency of each finding and its extent in the lungs were compared between the 2 patient populations. We found that the frequency of interstitial abnormalities such as ground-glass attenuation, reticulation, honeycombing, and consolidation was not significantly different between the 2 groups. Yet it is important to recall that, in contrast, there were significant differences in the frequencies of parenchymal micronodules and bronchial wall thickening, both of which are indicative of small-airway diseases; specifically, these conditions were more prominently observed in the patients with longstanding RA, which tendency apparently contributed to the higher incidence of the bronchiolitis pattern in this group. We therefore concluded that the incidence of bronchiolar abnormalities is associated with the duration of RA. The longstanding RA group appeared to be predisposed to complications … Address reprint requests to Dr. S. Mori, Clinical Research Center for Rheumatic Disease and Department of Rheumatology, Kumamoto Saishunsou National Hospital, 2659 Suya, Kohshi, Kumamoto 861-1196, Japan. E-mail: moris{at}saisyunsou1.hosp.go.jp