The association between Vitamin D Deficiency and Pulmonary Affection in Rheumatoid Arthritis Patients

Abstract

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease causing symmetrical articular destruction with extraarticular manifestations that include pulmonary manifestations, which are major contributors to morbidity and mortality. Aim of The Work:To detect the prevalence of vitamin D deficiency and its relationship to pulmonary affection in RA patients and correlate it with disease Activity . Patients and Methods:The study is a cross sectional one, carried out on fifty patients with RA recruited from the Chest and Rheumatology Outpatient Clinics of Al Hussein University Hospital. All patients diagnosed with RA who fulfilled the American Colleague of Rheumatology/European League against Rheumatism 2010 classification criteria. Results: In our study there was statistically significant (p-value = 0.002) increased DAS score in deficient patients (5.4 ± 0.8) when compared with insufficient patients (4.9 ± 0.4) and sufficient patients (4.1 ± 0.8). In our study there was statistically significant relation (p-value < 0.05) between vitamin D status and pulmonary manifestations (Exertional Dyspnea, Dry Cough, Chest Pain, Wheezing and Leathery Crepitation) which more frequent in deficient than insufficient and sufficient patients. In our study there was highly statistically significant (p-value < 0.001) decreased FVC in deficient patients (89.3 ± 20.1) when compared with insufficient patients (113.4 ± 7.1) and sufficient patients (114.8 ± 3.4). No statistically significant relation (p-value > 0.05) between vitamin D status and FEV1 & FEV1/FVC. Conclusion: RA disease activity score (DAS-28 score) and pulmonary manifestations in RA patients were more prevalent in Vitamin D deficient than insufficient and sufficient patients.

Vitamin D Status in Egyptian Patients With Psoriatic Arthritis and Its Relationship With the Disease Activity and Severity.

“…Our research didn't reveal statistically significant difference between patients and controls regarding vitamin D level that disagree with Radić et al 17 Mohammed et al 18 , Ibrahim et al 19 , Petho et al 20 , and Touma et al 21 who detected lower Vitamin D levels in psoriatic arthritis patients rather than healthy participants. This disagreement could be explained by our small sample size.…”

“…On the contrary, Rotondo et al 26 showed that vitamin D level was not correlated with inflammatory markers, furthermore, Ibrahim et al 19 and Sag˘et al 25 reported that vitamin D level was not correlated with CRP.…”