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Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry

Overview of attention for article published in Jornal Brasileiro de Pneumologia, August 2015
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Title
Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry
Published in
Jornal Brasileiro de Pneumologia, August 2015
DOI 10.1590/s1806-37132015000004518
Pubmed ID
Authors

Kawassaki, Alexandre Melo, Pereira, Daniel Antunes Silva, Kay, Fernando Uliana, Laurindo, Ieda Maria Magalhães, Carvalho, Carlos Roberto Ribeiro, Kairalla, Ronaldo Adib

Abstract

To determine whether simple diagnostic methods can yield relevant disease information in patients with rheumatoid arthritis (RA). Patients with RA were randomly selected for inclusion in a cross-sectional study involving clinical evaluation of pulmonary function, including pulse oximetry (determination of SpO2, at rest), chest X-ray, and spirometry. A total of 246 RA patients underwent complete assessments. Half of the patients in our sample reported a history of smoking. Spirometry was abnormal in 30% of the patients; the chest X-ray was abnormal in 45%; and the SpO2 was abnormal in 13%. Normal chest X-ray, spirometry, and SpO2 were observed simultaneously in only 41% of the RA patients. A history of smoking was associated with abnormal spirometry findings, including evidence of obstructive or restrictive lung disease, and with abnormal chest X-ray findings, as well as with an interstitial pattern on the chest X-ray. Comparing the patients in whom all test results were normal (n = 101) with those in whom abnormal test results were obtained (n = 145), we found a statistically significant difference between the two groups, in terms of age and smoking status. Notably, there were signs of airway disease in nearly half of the patients with minimal or no history of tobacco smoke exposure. Pulmonary involvement in RA can be identified through the use of a combination of diagnostic methods that are simple, safe, and inexpensive. Our results lead us to suggest that RA patients with signs of lung involvement should be screened for lung abnormalities, even if presenting with no respiratory symptoms.

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Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 1 7%
Unknown 14 93%
Readers by discipline Count As %
Medicine and Dentistry 1 7%
Unknown 14 93%