Rheumatoid arthritis (RA) affects the respiratory system in a number of ways, including interstitial lung disease, nodules, pleural effusion, bronchiolitis obliterans, and bronchiectasis.1Isolated small airways obstruction has been described in patients with RA.2-6 Some of the studies, however, included a predominance of smokers2 or patients who were ex-smokers in the analysis.3 4 One study found no evidence of an increase in airways obstruction.7 The incidence and frequency, therefore, of small airways obstruction in non-smoking patients with RA still remains unclear and the natural history of the condition is unknown.

We obtained detailed medical and smoking histories from 54 unselected patients with RA (ARA criteria) in 1988. Patients were questioned specifically regarding the presence of cough, wheeze, dyspnoea or sputum production and had a full respiratory examination. All patients had respiratory function tests and chest radiography. The history, …