RESEARCH - Pulmonary involvement in non-smoking patients with RA and AS without respiratory symptoms

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Clin Rheumatol. 2006 Mar;25(2):213-8. Epub 2005 Aug 10.

Pulmonary involvement in lifelong non-smoking patients with rheumatoid

arthritis and ankylosing spondylitis without respiratory symptoms.

Ayhan-Ardic FF, Oken O, Yorgancioglu ZR, Ustun N, Gokharman FD.

Department of Physical Medicine and Rehabilitation, Division of

Rheumatology, Ankara Education and Research Hospital, Ahmet Hamdi s. 20/12,

06170 Ankara, Turkey. figenardic@...

Pulmonary involvement seen in rheumatoid arthritis (RA) and ankylosing

spondylitis (AS) has been detected increasingly by using highly sensitive

diagnostic techniques such as high-resolution computed tomography (HRCT).

However, HRCT findings in healthy controls and the effects of smoking and

drugs have not been well studied. The aim of this controlled study was to

evaluate the relationships between disease-specific clinical, laboratory,

HRCT and pulmonary function test (PFT) findings in 20 RA patients using

methotrexate (MTX) and 20 AS patients using sulphasalazine who were

non-smokers and exhibited asymptomatic respiratory signs. For this purpose,

a total of 60 persons (40 patients and 20 healthy controls) were included in

this study. A restrictive pattern on PFT was detected in four patients (20%)

with AS, one patient with RA and one control (p<0.05). Fourteen patients

(70%) with RA and ten patients (50%) with AS had positive HRCT findings.

Only one patient (5%) in the control group had abnormal HRCT findings

(p<0.05). Interstitial lung disease (ILD) was the most frequently seen HRCT

finding in both the RA (35%) and AS (20%) groups. The chest expansion

measurement, the score of the visual analogue scale (VAS) for pain and

C-reactive protein (CRP) levels were statistically significantly better in

patients with AS having normal HRCT than in those with abnormal findings

(p<0.05). There was no correlation detected between HRCT and duration of

disease, disease activity markers, functional indexes and PFT in patients

with RA and AS. HRCT is a sensitive tool in detecting ILD in patients with

RA and AS with no signs and symptoms of pulmonary involvement and may be an

integral part of such work-up. However, future prospective studies are

needed to better determine if HRCT is in fact a predictor of subsequent MTX

toxicity.

PMID: 16091838

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=16091838

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