{"doi":"10.1038/s41598-021-02066-9","title":"High-titer rheumatoid factor seropositivity predicts mediastinal lymphadenopathy and mortality in rheumatoid arthritis-related interstitial lung disease","abstract":"Rheumatoid arthritis-related interstitial lung disease (RA-ILD) is a common connective tissue disease-related ILD (CTD-ILD) associated with high morbidity and mortality. Although rheumatoid factor (RF) seropositivity is a risk factor for developing RA-ILD, the relationship between RF seropositivity, mediastinal lymph node (MLN) features, and disease progression is unknown. We aimed to determine if high-titer RF seropositivity predicted MLN features, lung function impairment, and mortality in RA-ILD. In this retrospective cohort study, we identified patients in the University of Chicago ILD registry with RA-ILD. We compared demographic characteristics, serologic data, MLN size, count and location, and pulmonary function over 36 months among patients who had high-titer RF seropositivity (≥ 60 IU/ml) and those who did not. Survival analysis was performed using Cox regression modeling. Amongst 294 patients with CTD-ILD, available chest computed tomography (CT) imaging and serologic data, we identified 70 patients with RA-ILD. Compared to RA-ILD patients with low-titer RF, RA-ILD patients with high-titer RF had lower baseline forced vital capacity (71% vs. 63%; P = 0.045), elevated anti-cyclic citrullinated peptide titer (122 vs. 201; P = 0.001), CT honeycombing (50% vs. 80%; P = 0.008), and higher number of MLN ≥ 10 mm (36% vs. 76%; P = 0.005). Lung function decline over 36 months did not differ between groups. Primary outcomes of death or lung transplant occurred more frequently in the high-titer RF group (HR 2.8; 95% CI 1.1-6.8; P = 0.028). High-titer RF seropositivity was associated with MLN enlargement, CT honeycombing, and decreased transplant-free survival. RF titer may be a useful prognostic marker for stratifying patients by pulmonary disease activity and mortality risk.","journal":"Scientific Reports","year":2021,"id":177933,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9614,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":553610,"name":"Iazsmin Bauer Ventura","orcid":"0000-0003-1306-4241","position":1,"is_corresponding":false},{"id":285952,"name":"Cathryn T. Lee","orcid":"0000-0002-0963-7505","position":2,"is_corresponding":false},{"id":722954,"name":"R. Strykowski","orcid":"0000-0001-7827-6152","position":3,"is_corresponding":false},{"id":473637,"name":"Nicole Garcia","orcid":"0000-0002-1619-3359","position":4,"is_corresponding":false},{"id":722955,"name":"Robert D. Guzy","orcid":"0000-0001-8420-6177","position":5,"is_corresponding":false},{"id":666455,"name":"Renea Jablonski","orcid":"0000-0003-4458-6085","position":6,"is_corresponding":false},{"id":137155,"name":"Rekha Vij","orcid":null,"position":7,"is_corresponding":false},{"id":285957,"name":"Mary E. Strek","orcid":"0000-0002-7671-1023","position":8,"is_corresponding":false},{"id":105247,"name":"Jonathan H. Chung","orcid":"0000-0001-7011-0588","position":9,"is_corresponding":false},{"id":285949,"name":"Ayodeji Adegunsoye","orcid":"0000-0002-7015-9610","position":10,"is_corresponding":false},{"id":722953,"name":"Albina Tyker","orcid":"0000-0003-3911-0568","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-18T23:47:36.112170Z","pmid":"34819525","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}