A COMPARATIVE STUDY OF PULMONARY INVOLVEMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS
Ravikumar P, Dwijen Das, Kallol Bhattacharjee
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder that affects many organs but principally affects joints. Pulmonary manifestations in RA are varied as the pleura, lung, parenchyma, airways and pulmonary vasculature can be involved. Aims-To measure the alterations of lung function parameters with the help of spirometry in patients of RA in a semi-urban population of a developing country. MATERIALS AND METHODS A total of fifty patients of RA were recruited into the
... study. Different parameters studied were forced vital capacity (FVC), FVC%, forced expiratory volume in 1s (FEV1), FEV1%, FEV1/FVC, forced expiratory flow (FEF25-75), FEF25-75%, peak expiratory flow rate (PEFR), PEFR%. Settings and Design-A prospective hospital based study was conducted for one year period. Statistical Analysis-The group data was introduced with the mean and standard deviation. Quantitative and qualitative data were analysed using student's t-test and Chi-square tests respectively. P values less than 0.05 were considered as statistically significant. RESULTS Out of 50 cases, majority (70%) of cases were females and belonged to the age group of 31 to 40 years (44%). Among respiratory symptoms, dyspnoea was the most common (20%) followed by cough (14%), chest pain and wheezes (10% each). The Rheumatoid factor and anti CCP positivity was seen in 76% and 82% of patients with significant association with PFT abnormalities (p= 0.04 and p= 0.01) respectively. The high disease activity were observed to have PFT abnormalities (p=<0.05). Chest X-rays findings were hyperinflation (36%), interstitial pattern (28%) and volume loss (08%). In 86% of patients, HRCT showed the most common findings were bronchiectasis (34%), rheumatoid nodules (26%) and air trapping (20%). Among RA patients, 28 (56%) were normal, 08 (16%) had obstructive and 14 (28%) had restrictive lung diseases. CONCLUSION Pulmonary abnormalities were found significantly higher in female patients with 31-40 years of age group, rheumatoid factor and anti CCP positivity, high disease activity score patients. It is recommended that in the above circumstances, patients with RA should be follow up on a regular basis and PFT should be done for the early diagnosis of pulmonary involvement.