Pulmonary function test with DAS28 score and duration of Rheumatoid arthritis: A comparative analysis
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
Background: Pulmonary involment in Rheumatoid arthritis is major health concern in the field of rheumatology. Evidence suggests one of commonest cause of mortality in RA. Objective: We found the abnormalities of pulmonary function test in patients with Rheumatoid Arthritis in tertiary care centre. Patients and Methods: This is a comparative, analytical, cross sectional, Institution- based, single centre study.We included all adult willing patients of Rheumatoid arthritis (age >18) and selected them based on 2010 ACR/EULAR criteria. Severity was assessed by number of joints involve in both upper & lower limb, along with ESR, CRP, Anti CCP level. Pulmonary function tests were performed on RA patients with or without abnormal HRCT patterns using a standard protocol. Forced expiratory volume in the first second (FEV1), FEV1/FVC ratio (a sensitive index of overall airway obstruction), and forced expiratory flow from 25% to 75% of VC (FEF25–75, a specific index of small airway function). Results: Present study conducted in 50 patients of Rheumatoid arthritis who meet the inclusion criteria.Out of 50 RA patients, pulmonary involvement was observed in 25 patients , identified by Spirometry, CXR, HRCT. Mean age of the patients was 35.01 ranging from 26 to 56 years.Out of 50 RA patients 14 was male and 36 was female. Though RA is more common in female sex but pulmonary involvement was more common in male sex.Pulmonary involvement is more common in age group < 40 years. There is a significant correlation between DAS28 score( indicator of disease activity ) with pulmonary involvement. Patients having high disease activity , more is the pulmonary involvements. Most common form of pulmonary involvement is ILD followed by obstructive lung disease like chronic bronchitis, bronchiectasis etc. HRCT is the most common stool for detection of Pulmonary involvement in Rheumatoid arthritis.HRCT abnormality, most are Restrictive on spirometry (FEV1/FVC) < 80% of predicted value. And this relation is statiscally significant as P value is 0.001(<0.05) by Chi-Square test.Patients having more the disease duration, more the pulmonary involvement. This association is statically significant as p value is 0.001 (<0.05). Conclusions: Pulmonary function test is the cheapest and bedside tool to detect the pulmonary involvement in rheumatoid arthritis.
Authors and Affiliations
Gantait K, Jamirul I, Barman H, Santra T
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