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Clinical, spirometric and radiological characteristics of Brazilian rheumatoid arthritis patients

Alexandre Melo Kawassaki, Suzana Pinheiro Pimenta, Fernando Kay, Marianne Karel Vercosa-Kawassaki, Ieda Maria Magalhaes Laurindo, Carlos Roberto Ribeiro Carvalho, Ronaldo Adib Kairalla
European Respiratory Journal 2012 40: P3977; DOI:
Alexandre Melo Kawassaki
1Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
2Pulmonology, Hospital 9 de Julho, Sao Paulo, SP, Brazil
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Suzana Pinheiro Pimenta
1Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
2Pulmonology, Hospital 9 de Julho, Sao Paulo, SP, Brazil
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Fernando Kay
3Radiology, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
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Marianne Karel Vercosa-Kawassaki
4Intensive Care Unit, Hospital Estadual Vila Alpina (HEVA), Sao Paulo, SP, Brazil
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Ieda Maria Magalhaes Laurindo
5Rheumatology, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
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Carlos Roberto Ribeiro Carvalho
1Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
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Ronaldo Adib Kairalla
1Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
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Abstract

Rheumatoid Arthritis (RA) is a common inflammatory disease, and pulmonary involvement is usual. An algorithm has been proposed for evaluation and management of RA patients with suspected interstitial lung disease, based on chest radiograph, physical examination and symptoms (Kim, E.J. et al. Chest 2009;136:1397-1405). Objective: To describe clinical, spirometric and radiological characteristics of Brazilian RA patients using low-cost evaluation. Methods: Patients with RA, irrespective of having pulmonary involvement, were evaluated, and data regarding pulse oximetry, spirometric measures and digital chest radiograph were obtained. Results: 248 RA patients were analyzed. 85% were female, mean age was 56±10 years, median disease onset time was 16 years (IQR 7,75-24). The most common exposition was mold (22%). 50% had no smoking history, 17% were current smokers and 33% were former smokers. Pulse oximetry was normal (above 94%) in 87%. MRC dyspnea index 1 or 2 were observed in 50% and 32%, respectively. Most commonly used drugs were Methotrexate (92%), Prednisone (80%) and Chloroquine (78%). Spirometry was classified as normal (70%), obstructive (11%), restrictive (11%), mixed (5%) and unspecified (3%) patterns. At the moment, data for chest radiograph is available for 71 patients (29%), parenchymal abnormalities were observed in 56%, mainly linear (38%) and reticular opacities (18%). Conclusion: This is the first study in Brazilian RA patients to analyze digital chest radiographs and to evaluate lung abnormalities. Spirometric alterations are common in RA patients. Abnormalities in digital chest radiographs were more frequent than previously described in convencional radiographs.

  • Interstitial lung disease (connective tissue disease)
  • Epidemiology
  • Spirometry
  • © 2012 ERS
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Clinical, spirometric and radiological characteristics of Brazilian rheumatoid arthritis patients
Alexandre Melo Kawassaki, Suzana Pinheiro Pimenta, Fernando Kay, Marianne Karel Vercosa-Kawassaki, Ieda Maria Magalhaes Laurindo, Carlos Roberto Ribeiro Carvalho, Ronaldo Adib Kairalla
European Respiratory Journal Sep 2012, 40 (Suppl 56) P3977;

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Clinical, spirometric and radiological characteristics of Brazilian rheumatoid arthritis patients
Alexandre Melo Kawassaki, Suzana Pinheiro Pimenta, Fernando Kay, Marianne Karel Vercosa-Kawassaki, Ieda Maria Magalhaes Laurindo, Carlos Roberto Ribeiro Carvalho, Ronaldo Adib Kairalla
European Respiratory Journal Sep 2012, 40 (Suppl 56) P3977;
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