Pulmonary function tests and high resolution computed tomography of the lungs in patients with rheumatoid arthritis

doi:10.1136/ard.56.10.596

Annals of the Rheumatic Diseases 1997;56:596-600; doi:10.1136/ard.56.10.596

Ann Rheum Dis 1997;56:596-600 ( October )

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Pulmonary function tests and high resolution computed tomography of the lungs in patients with rheumatoid arthritis Bernard Cortet,^a Thierry Perez,^b Nicolas Roux,^a René-Marc Flipo,^a Bernard Duquesnoy,^a Bernard Delcambre,^a Martine Rémy-Jardin^c

^a Department of Rheumatology, CHRU Lille, Hôpital R Salengro, Lille, France , ^b Departments of Pneumology , ^c and Radiology , ^d CHRU Lille, Hôpital Calmette, Lille, France

Correspondence to: Dr B Cortet, Department of Rheumatology, CHRU Lille, Hôpital R Salengro, 2 Avenue Oscar Lambret, 59037, Lille Cedex, France.

Accepted for publication 30 June 1997

OBJECTIVE $---$ To compare the results of pulmonary function tests (PFTs) and high resolution computed tomography (HRCT) of the lungs in rheumatoidarthritis (RA)patients.
METHODS $---$ Sixty eight patients (54 women, 14 men) fulfilling the revised criteria for RA were consecutively included in a transversalprospective study. Their mean age was 58.8 years (range: 35-82)and the mean duration of the disease was 12 years (range: 5-16).Rheumatoid factor was positive in 52 patients (76.5%). Fifty twopatients (76.5%) were lifelong non-smokers. Detailed medical anddrug histories were obtained. PFTs comprised spirometry and gastransfer measurements. Results for PFTs were expressed as percentageof predicted values for each individual adjusted for age, sex,and height. HRCT was undertaken with a Siemens SomatomPlus.
RESULTS $---$ A significant decrease of FEV1/FVC, FEF25%, FEF50%, FEF75%, FEF25-75%, and TLCO was observed (p<0.05) and 13.2% of the patientshad a small airways involvement defined by a decrease of FEF25-75%below 1.64 SD. The most frequent HRCT findings were: bronchiectasis(30.5%), pulmonary nodules (28%), and air trapping (25%). Thepatients with small airways involvement had a high frequency ofrecurrent bronchitis (75% v 34%, p=0.05) and bronchiectasis (71%v 23%, p=0.019). The patients with bronchiectasis were characterisedby low values of FEV1, FVC, FEF25-75%, and TLCO (p<0.01), a highprevalence of small airways involvement (29% v 5%, p=0.019), anda low prevalence of HLA DQA1 *0501 allele (14% v 33%, p<0.05).
CONCLUSION $---$ This study suggests a significant association between small airways involvement on PFTs and bronchiectasis on HRCT in unselectedRApatients.

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