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Role of spirometry in the evaluation of lung involvement in non-smoker rheumatoid arthritis patients

Biswajit Das, Md. Mahboob Alam, Parasar Ghosh.

Background: Interstitial lung disease (ILD) is a common and serious complication of rheumatoid arthritis (RA). Risk of obstructive lung disease is also higher in adult RA.

Aim and Objective: This study aimed at evaluating the frequency of obstructive and restrictive pattern of pulmonary impairment in non-smoking Indian RA patients.

Materials and Methods: A cross-sectional study involving adult RA patients was carried out for 1˝ years. The study parameters included tender joint counts, swollen joint counts, erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, clinical disease activity index, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, forced expiratory flow between 25 and 75% of vital capacity, and peak expiratory flow rate (PEFR). Fisher’s exact test was used to compare the data.

Results: Out of 203 patients included in the study, 177 were female. Spirometry was normal in 63% of female and 42% of male. Overall frequency of restrictive, obstructive, and mixed pattern of spirometry was 33.3%, 0.6%, and 2.8% in females, respectively, in contrast to 42.3%, 11.5%, and 3.8% in males. Moderate to very severe degree of restrictive pattern of impairment was noted in 9.6% of female and 15.4% of male patients. Decreased FEV1/FVC was more frequent in male patients compared to female (15.4% vs. 3.4%). PEFR was within normal limit in about 86% of patients.

Conclusion: One-third of female and about two-fifth of male patients had restrictive pattern of spirometry with most being mild in nature. Obstructive disease was uncommon in female in contrast to male.

Key words: Rheumatoid Arthritis; Interstitial Lung Disease; Non-Smokers

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