Asymptomatic Interstitial Lung Disease in Patients with Rheumatoid Arthritis

Document Type : Original Article

Authors

1 Departments of Internal Medicine, Al-Azhar University, Egypt

2 Departments of Radiology, Al-Azhar University, Egypt

Abstract

Background: Rheumatoid arthritis (RA) has long been considered a systemic disease with extra-articular involvement including interstitial lung disease (ILD). ILD is a common extra-articular manifestation of rheumatoid arthritis (RA) and a significant cause of morbidity and mortality. Early detection and treatment for interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA) may ameliorate disease progression. Objectives: This study was done to evaluate the frequency of asymptomatic interstitial lung disease in patients with rheumatoid arthritis and to compare it with the clinical status. Methods: The current study enrolled 60 RA patients were diagnosed according to 2010 ACR-EULAR criteria. All patients were subjected to full history taking and thorough clinical examination. ESR, CRP, Anti CCP and RF were done to the patients. RA disease activity was assessed using DAS 28 score, Radiological joint damage was assessed by larsen score. HRCT and pulmonary function test were also done. Results: Out of 60 RA patients 51 had RA-ILD identified by HRCT. There was statistically significant increase in the mean of the age and DAS 28 score among RA patients with ILD when compared to that of the RA patients with out ILD (P<0.01 and P<0.01). There was a statistically significant positive correlation between HRCT score and disease duration, DAS score and Duration of methotrexate therapy (P<0.01 to all). There was a statistically significant negative correlation between HRCT score and (FVC), (FEV1) and (TLC). Conclusions: Asymptomatic preclinical ILD has a high prevalence in RA patients, proved by HRCT and pulmonary function test and lung involvement should always be considered in RA patients even in absences of respiratory symptoms.