A Study of Interstitial Lung Disease Associated With Rheumatoid Arthritis

Abstract

BACKGROUND: Rheumatoid Arthritis (RA) is a common systemic disease that manifests as inflammatory arthritis of multiple joints and produces a wide variety of extra-articular manifestations. Interstitial Lung Disease (ILD) is one of the important pulmonary manifestation of RA like other Connective Tissue Disease(CTD). However RA-ILD differs from CTD-ILD in terms of histopathology and prognosis. OBJECTIVES: To study the clinical features, laboratory profile, radiological patterns, pulmonary function tests including spirometry and DLCO in patients with RA-ILD. MATERIALS AND METHODS: This study was a cross sectional study carried out in the department of Respiratory Medicine at MMIMSR,Mullana, Haryana. A total of 10 patients were included in the study after verifying inclusion and exclusion criteria. After complete history and investigations details were documented in a proforma. RESULTS: A total of 10 patients comprising of 3 males and 7 females with a mean age of 56.5 years were included. Dry cough (100%) was the most common presenting complaints followed by excertional dyspnoea (80%). Among the 10 patients 8 were smokers. Bilateral basal Velcro creps was the most common feature (70%) followed by clubbing(20%).In HRCT the most common pattern was UIP (typical UIP-10%, probable UIP-70%) followed by Non-IPF pattern (20%). Spirometry showed restrictive pattern in all cases. DLCO was severely reduced in typical UIP pattern. CONCLUSION: HRCT chest is the most sensitive tool for early diagnosis of ILD, while DLCO is most sensitive for monitoring the prognosis. RA-ILD can be prevented and treated at an early state.