Respiratory involvement in rheumatoid arthritis physiologic abnormalities and determinants of radiographic

dc.contributor.authorMohamed Ismail, Asmahan
dc.date.accessioned2017-08-23T09:04:43Z
dc.date.available2017-08-23T09:04:43Z
dc.date.issued2002
dc.description.abstractPulmonary disease in rheumatoid arthritis (RA) may take many forms including pleural lesions, lung nodules, interstitial pulmonary fibrosis, and obliterative bronchiolitis. In 1947, Ellman first described diffuse bilateral interstitial changes in the lungs of a patient with rheumatoid arthritis and many similar cases have been reported throughout the world. In addition to the distinct lung disorders mentioned above, low grade disease of the respiratory tract, and even considerable impairment of respiratory function, may occur in rheumatoid arthritis in spite of radiologically normal lungs. M. Linstow and colleagues in 1994 have showed that patients suffering from RA have prominent functional pulmonary abnormality. The aim of this study is to evaluate prevalence and characteristic of respiratory involvement in patients with rheumatoid arthritis. The characteristic will be determined by doing a lung function test in all patient confmned to have rheumatoid arthritis while evaluation of the radiographic changes is done with a chest radiograph. The second objective is to assess the relationship between disease activity and lung involvement. The study was carried out during a period between November 2000 to October 2001. The patients were recruited from Rheumatology Clinic and medical wards, Hospital Universiti Sains Malaysia who fulfllled inclusion and exclusion criteria. All patients should satisfy the American Rheumatic Association criteria for Rheumatoid Arthritis. Once patients were identified, a brief explanation of the study was made. Baseline investigations includes full blood count, erythrocyte sedimentation rate, renal and liver function test. The immunological system is evaluated by doing a rheumatoid factor, complement level and C-reactive protein. Lung function test were performed for all patients and highest reading was taken as the fmal result. A chest radiograph was done on all patients included in this study. They were also asked for associated respiratory symptoms of chronic cough, shortness of breath and assessed of presence of basal crepitations clinically. There were significant different in the mean FVC, FEVt and FEVt/FVC of patients with RA as compared to normal population. The most common types of respiratory function abnormality in patients with RA was restrictive type where the FVC% was less than 80%. Assessment of chest radiograph revealed twelve abnormalities in the chest xray of RA patients and out of this , 50% of the lung function test is normal. The most common abnormalities detected is peribronchial and/or pleural thickening and interstitial lung disease. While 84.6% of patients with normal chest x-ray had restrictive type of abnormality on their lung function test. There were no relationship between the sign and disease activity with lung function test. The physiological function of the respiratory system in rheumatoid arthritis patients are abnormal eventhough they remain asymptomatic. The most common abnormalities in rheumatoid lung disease by doing the lung function test is the restrictive type. Lung function test predicts lung abnormalities better than assessment of chest radiography. The lung function is not affected by sign, chest radiographic fmding and activity of disease. However there is suggestion that the longer the disease, the more likely to have abnormal and more severe impairment of the lung function test.en_US
dc.identifier.urihttp://hdl.handle.net/123456789/4413
dc.language.isoenen_US
dc.subjectRheumatoid arthritis (RA)en_US
dc.titleRespiratory involvement in rheumatoid arthritis physiologic abnormalities and determinants of radiographicen_US
dc.typeThesisen_US
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