Assessment of Pulmonary Function Abnormalities in Rheumatoid Arthritis Patients

Abstract

Introduction: “Collagen vascular disease” (CVDs) is the name of a group of diseases that affect the connective tissue. Collagen is a protein-based connective tissue that forms a support system for skin. Connective tissue holds bones, ligaments, and muscles together. Collagen vascular disease is sometimes also called connective tissue disease. Collagen vascular diseases can be heritable (inherited from one’s parents) or autoimmune (resulting from activity of the body’s immune system against itself). Aim: The current study is designed to: (Detect and assess abnormalities of pulmonary function in Rheumatoid arthritis patients who have respiratory symptoms suggesting pulmonary involvement, Detect and assess abnormalities of pulmonary function in Rheumatoid arthritis patients who are free of respiratory symptoms, Compare the abnormalities of pulmonary function between two mentioned groups). Patients and Methods: This study is comparative cross-sectional study that was conducted at Ain-shams University Hospital in Chest and Rheumatology department to evaluate and compare the abnormalities of PFTs in RA patients who have respiratory symptoms and who are free (symptomatic and asymptomatics), age 20 to 60 years. Sociodemograghic characteristics and respiratory symptoms were assessed using LTRC. Pulmonary function test then were done to both group using spirolab111 according to American Thoracic Recommendations. Results: There was no statistically significant difference between both group regarding age, sex, and BMI. Among 20 symptomatic patients with RA, 16 cases (80%) had abnormal PFTs, While among the other 20 asymptomatic group only 8 cases (40%) had abnormalities in PFTs. Spirometric results of current study showed that majority of symptomatic group have small airway disease obstructive pattern(60%) ,followed by restrictive pattern(45%) and the least is large airway obstructive pattern (25%). On the other hand, in asymptomatic group majority have predominant normal pattern (60%), followed by small airway disease (25%), then restrictive pattern (10%), and the least is obstructive pattern (5%). Cough and exertional dyspnea were the most frequent among symptomatic group. Conclusion: Pulmonary function tests can be used as indicators of disease activity in Rheumatoid Arthritis, Lung function data can be used to stratify abnormalities in a clinically useful manner, Longitudinal studies are needed to ascertain the effect of therapy on these abnormalities, Overall, the results from this study demonstrated that the high incidence of pulmonary function abnormalities observed in the study patients was unexpected and suggests that all patients with RA should undergo PFTs for complete assessment.