Background Lung involvement is a common extra-articular manifestation of rheumatoid arthritis (RA) that confers significant morbidity and mortality. However, this issue has not been sufficiently studied in Egyptian patients.
Objectives To assess the prevalence of pulmonary abnormalities by high resolution computed tomography (HRCT) chest in RA patients and their association with clinical variables.
Methods Ninty-six patients with RA were assessed regarding their age, gender, duration of RA disease, sicca symptoms, presence of subcutaneous rheumatoid nodules, rheumatoid factor, respiratory symptoms, use of medications, disease activity of RA using Disease Activity Score 28 (DAS28), basic laboratory investigations and pulmonary abnormalities in plain x-ray and HRCT.
Results HRCT abnormalities were identified in 25% of the patients; 58.3% had respiratory symptoms while 41.7% were subclinical. Dyspnea and cough were the most frequent symptoms. HRCT abnormalities were interstitial lung disease (ILD) in 11 patients (11.5%), pleural involvement in 8 patients (8.3%), consolidation in 4 patients (4.2%), diffuse alveolar hemorrhage in 3 patients (3.1%), bronchiectasis in 2 patients (2.1%), and apical fibrosis with cavitation in only 1 patient (1%). Patients with dyspnea, cough, chest rales, cutaneous rheumatoid nodules, and who received disease modifying antirheumatic drugs (DMARDs) combination were more likely to have HRCT abnormalities.
Conclusions Pulmonary involvement is not uncommon in RA patients, and HRCT is a sensitive tool in pulmonary evaluation.
Disclosure of Interest None declared