Pulmonary involvement in rheumatoid arthritis : correlation of radiographic, high-resolution computed tomography and pulmonary function tests with the clinical manifestations

Abstract EN

Aim of Study : pulmonary involvement is one of the most common extra-articular manifestations of rheumatoid arthritis (RA).

Prospective studies have reported a prevalence of pulmonary involvement of 19-80 %.

This study was designed to determine the prevalence of pulmonary involvement in RA patients, to evaluate radiographic, high-resolution computed tomography (HRCT) as well as pulmonary function tests (PFTs), and to assess their correlation with the clinical manifestations.

Methodology : the study included 46 RA patients, fulfilling the revised American College of Rheumatology (ACR) criteria for RA.

They were 38 women and 8 men, their age ranged from 24 to 67 years.

All patients underwent a detailed clinical assessment, chest radiography, chest HRCT scanning, and full PFTs.

Also detailed medical and drug histories.

Results : Twenty-nine patients (63 %) showed clinical respiratory manifestations, the main complaint was dyspnea, followed by recurrent bronchitis and cough.

HRCT scan was abnormal in 35 patients (76 %).

The most frequent findings were fibro sing alveoli is (26 %), emphysematous bullae (22 %), air trapping (19.5 %) and bronchiectasis (17.5 %).

There was a significant decrease in pulmonary function tests including FEV1, FVC, FEF25 %, FEF50 %, FEF 75 %, FEF25-75 % and TLCO (p < 0.05).

There was no significant relation between pulmonary involvement and age, sex, disease duration, disease severity or extra-articular manifestation.

Conclusion : this study suggests that HRCT scanning is a useful, sensitive and non-invasive tool for recognition of RA-associated lung diseases.

The presence of dyspnea should prompt physicians to request a chest HRCT scan even without restrictive changes on chest radiographs in RA patients.