Pulmonary involvement in rheumatoid arthritis

Abstract

The primary objective of this investigation was to assess the relationships between clinical characteristics, lung involvement, and frequency of pulmonary involvement in rheumatoid arthritis (RA). Using high-resolution computed tomography (HRCT) and pulmonary function tests (PFT), we prospectively evaluated 52 patients with RA (eight males and 44 females, mean age 53.6 years). The HRCT was abnormal in 35 patients (67.3%), the most frequent abnormalities being reticulonodular patterns, which were found in 22 patients (62.9%), ground-glass attenuation (20%), and bronchiectasis (17%). In this group of patients, PFT results were normal in 13 patients (37%). Titers of rheumatoid factor and erythrocyte sedimentation rate were significantly higher in abnormal HRCT presence. Higher Larsen's score, advanced age, and severe disease were significant risk factors for lung involvement (p<0.001, p<0.01, and p<0.01, respectively) and are suggested by our data to be statistically significant predictors of lung involvement in RA.

Alterações de tomografia pulmonar de alta resolução em pacientes com artrite reumatoide e suas associações com variáveis clínicas, demográficas, sorológicas e terapêuticas

“…The analysis of the data of the present study shows that most patients with RA (55%) have some type of CT changes. That high prevalence of fi ndings has been confi rmed by other authors, such as Zrour et al, 11 who have reported changes in 49.3% of 75 patients from Tunisia, and Bilgicki et al, 3 who have reported them in 67.3% of 52 patients in Turkey. In addition, Teraski et al, 12 studying patients with RA and respiratory symptoms, have reported CT changes in 90% of them.…”

“…Tobacco, a potentially harmful agent to the lungs, is also an aggravating factor of RA, causing not only a more aggressive disease, but also the appearance of more extra-articular manifestations. 3 The present study aimed at assessing the tomographic fi ndings of RA patients of a single rheumatology center in southern Brazil, and their possible correlation with the clinical and serological fi ndings of the disease.…”

“…2 The prevalence of pulmonary changes in RA patients varies in the literature. Part of that variability can be explained by the genetic background of the population studied, due to the infl uence of genes, such as those of HLA DR4 and HLA DR1, 2,3 on the phenotype of the disease. Genetic polymorphisms of the HLA-B40 and B54 are associated with the presence of pulmonary changes, especially fi brosis and bronchiolitis.…”

Rheumatoid Arthritis-Associated Interstitial Lung Disease

“…The majority of cases of RA-ILD occur in patients between the ages of 50 and 60 years. While several studies 13,[15][16][17]20 have reported smoking, male gender, and longstanding RA to be risk factors for the development of ILD, other reports 13,14,16,17,19 have not shown any significant associations. In addition, genetic associations (human leukocyte antigen B40 and ␣ 1 -antitrypsin) have been described.…”

“…Studies [12][13][14][15][16][17][18][19] have reported a prevalence as low as 4% and as high as 68%. The majority of cases of RA-ILD occur in patients between the ages of 50 and 60 years.…”