Background: Pulmonary manifestation is one of the most common extra-articular features in rheumatoid arthritis (RA) leading to significant morbidity. Lung function testing helps in identifying the type of respiratory defect. Early detection helps in effective management of the lung involvement in RA. Aims and Objectives: In this study, we compared the lung function of RA patient with the normal controls. Materials and Methods: Spirometry was performed in 100 participants (50 RA patients and 50 normal controls). Lung parameters such as forced vital capacity, forced expiratory volume in 1 s, forced expiratory flow in 25-75%, and peak expiratory flow rate were measured. Statistical analysis was performed, P < 0.05 was considered statistically significant. Result: In this study, restrictive ventilatory defect was seen in 64% of patients, and obstructive ventilatory defect was seen in 10% of patients. Pulmonary function abnormalities are common in asymptomatic rheumatoid patients which were found to be restrictive defect. Conclusion: Restrictive ventilatory defect may be due to idiopathic pulmonary fibrosis characterized by high levels of rheumatoid factor, antinuclear antibody and deposits of immunoglobulin A, and complement on the alveolar wall. Screening of RA patients with spirometer helps in early detection of pulmonary involvement.
Rheumatoid arthritis is an autoimmune disease, causing chronic inflammation of small joints in hands and feet. The chronic inflammation and corticosteroid use in rheumatoid patients predispose them to insulin resistance and diabetes. Hydroxychloroquine, a proven drug in rheumatoid arthritis, seems to be beneficial in diabetes and also reduces the risk of cardiovascular events. This study was done to find out the role of hydroxychloroquine on the glycemic status and lipid profile in Rheumatoid patients having treatment with Diabetes mellitus. 50 patients with both RA and DM in the middle age group were categorized into HCQ and Non-HCQ group. Both the groups were followed up for 6 months. Their glycemic status and lipid profile were compared by measuring FBS, PPBS, HbA1C, triglycerides, total cholesterol, VLDL, LDL and HDL. Statistical analysis was done by student t test. The mean FBS, PPBS, HbA1C values in HCQ Group patients decreased significantly from 155.16, 200.12 and 8.26 to 135.80, 174.60 and 7.49 respectively in the follow-up period. In the Non-HCQ group, there was no significant change in mean FBS and PPBS after 6 months. Mean HbA1C increased from 8.13 to 8.33 in Non-HCQ group. Triglycerides, total cholesterol, VLDL and LDL also were found to be reduced in patients who had taken HCQ. In Rheumatoid patients with diabetes, use of HCQ improves their glycemic status and reduces the lipid abnormalities.
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