Pulmonary Manifestations in Patients of Rheumatoid Arthritis and its Correlation with Severity of Disease.

ABSTRACT

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology marked by symmetric, peripheral polyarthritis. RA has a prevalence of 1-2% in the general adult population. The mortality rate in patients with RA increases during the course of the disease, with a tendency to accelerate after 15 yearsAim: To study the pulmonary manifestations and their severity using [Disease Activity Score (DAS)-28 score] in patients of RAMaterials and methods: Present study was conducted in the Department of Medicine, Sardar Patel Medical College and Associated Group of Hospitals Bikaner, Bikaner, Rajasthan, India, on 100 patients. This study was a cross-sectional, observational study conducted over 1 year. Consecutive cases of RA patients attending the outpatient department or admitted to the medicine wards were selected according to the inclusion and exclusion criteriaResults: Pulmonary manifestation was present in a total of 38% of cases, while the remaining 62% of cases had no pulmonary manifestation. The presence of comorbidity and C-reactive protein (CRP) was significantly associated with pulmonary manifestation in RA patients. On high-resolution computed tomography (HRCT), the most common finding was interstitial lung disease (ILD) (60.5%), with usual interstitial pneumonia (UIP) as the most common pattern. On performing a pulmonary function test (PFT), 33 patients (86.84%) had an abnormal result, with restrictive as the most common patternConclusion: The patients of RA, especially those with advanced age, long duration of disease, male sex, and associated comorbidity, should be screened for pulmonary complications of RA using X-ray chest and PFT, supplemented by HRCT chest wherever required.