Abstract
Objective: Early detection of Asymptomatic subclinical interstitial lung disease (ILD) (without respiratory symptoms) in patients with rheumatoid arthritis (RA) by high-resolution computed tomography (HRCT), chest radiography and pulmonary function tests (PFTs) and to study the possible role of methotrexate (MTX) therapy.
Patients &Methods: Fifty patients with RA were included in this study who attended Outpatient Clinics of Rheumatology and Chest Departments, Zagazig University Hospitals. They were 40 females and 10 males and classified into 2 groups according to MTX therapy and both groups were evaluated clinically, laboratory, pulmonary function tests (PFTs), chest radiography and by HRCT for detection of interstitial lung disease (ILD).
Results: that 46% (23/50) of RA patients were diagnosed as RA-ILD by HRCT and PFTs (30% (15/50) were in group 1 MTX therapy and 16 % (8/50) were in group 2, while 54% (27/50) did not meet criteria for ILD and were therefore designated as RA-no ILD. Compared with RA- ILD cases in group 2, RA-ILD patients in group 1were older and had longer disease duration, higher articular disease activity without significant difference; however they had more significant PFT and radiological abnormalities.
Conclusion: Lung involvement should always be considered in patients with RA particularly those on methotrexate therapy even in absence of chest symptoms. Diagnosis can be challenging since patients are unlikely to report dyspnea due to an overall decrease in physical activity with advanced arthritic symptoms. A tight control by PFTs, chest radiography and/orHRCT is binding and could affecting therapy plans.
- © 2014 ERS
