EVALUATION OF DLCO AS AN EARLY DETECTOR OF PULMNARY INVOLVMENT IN RHEUMATOID ARTHRITIS PATIENTS WITHOUT RESPIRATORY COMPLAINTS

Abstract

Interstitial lung disease (ILD) is an increasingly recognized complication of rheumatoid arthritis contributing to significantly increased morbidity and mortality. Diagnosis can be challenging since patients are unlikely to report dyspnea due to an overall decrease in physical activity with advanced arthritic symptoms. Additionally, the risk of death for RA patients with ILD was 3 times higher than in RA patients without ILD that’s why early detection and management of RA-ILD is essential. In view of the above, the present study was undertaken to assess the value of DLCO in early detection of pulmonary involvement in non-smoker patients with Rheumatoid arthritis, normal Chest X-ray &clinically free of respiratory symptoms. The study included 29 females and one male ranging in age from 21 to 66 years by mean 42.6 ± 1.9 years who underwent PFTs and DLCO. The results obtained were collected, tabulated and submitted for statistical analysis.

The following results were obtained: 1) Among the 30 patients with RA, 20 cases (66. 67%) had diffusion defect 17 had mild defect and 3 cases had moderate diffusion defect. 2) A highly significant Positive correlation was found between duration of RA (months) and the DLCO severity (P value <0.001). 3) It was found that there is no correlation between RF levels and DLCO severity 4) In Spirometric results of the present study, normal pattern was the predominant pattern followed by Restrictive pattern & small airway obstruction and the least incidence was obstructive pattern. 5) There was a statistically significant correlation between DLCO severity and decrease of FVC. 6) Methotrexate therapy was higher among patients with abnormal DLCO. Even though on further analysis there was no significant correlation between duration of MTX use and DLCO severity.