A Study on the Pulmonary Manifestations of Rheumatoid Arthritis from a North Indian Town

Rheumatoid arthritis (RA) is a chronic systemic disease of unknown etiology characterized by articular involvement, extra-articular involvement, and the presence of serum rheumatoid factor. Pulmonary involvement in RA is a common extra-articular manifestation of rheumatoid arthritis (RA) that confers significant morbidity and mortality. We undertook this study to determine the prevalence and spectrum of pulmonary abnormalities in patients with rheumatoid arthritis (RA) from a North Indian town. 62 patients who met the American College of Rheumatology (formerly the American Rheumatism Association) 1987 classification criteria for RA were subjected to clinical examination of chest, X-Ray-chest (CXR), pulmonary function tests (PFT) and high resonance computed tomography (HRCT). 40.3% patients had some pulmonary symptoms with exertional dyspnoea in 21%, cough with expectoration in 17.7%, fine respiratory rales in 11.3%, patients X-ray chest bilateral lower zone haziness in 16% and prominent pulmonary vasculature in 3.2%. 43% had abnormal PFT-restrictive pattern in 29%, obstructive pattern 8% and mixed pattern in 6.4%. HRCT revealed abnormal findings in 33.8% commonest being ground glass pattern in both lower lobes 19.3%, sub pleural reticulations in 9.6%, pleural thickening in 3.2% and pulmonary vascular prominence in 1.6%. To provide optimal treatment, physicians must always consider the possibility of associated pulmonary manifestations when patients with RA are evaluated.