Abstract
Our objective was to try to evaluate lung affection and to correlate an easier and cheaper method with the high-resolution computed tomography (HRCT) findings in patients with RA. Thirty-six RA patients were selected for HRCT lung scan (twelve patients with altered pulmonary function test (PFT) and 24 with normal PFT). The American Thoracic Society criteria were followed for the pulmonary test. Clinical and laboratory variables were recorded. A statistical analysis was done by Kaplan–Meyer survival curve and ROC curve. When HRCT was evaluated in all patients, only sixteen had an HRCT normal and twenty patients showed some radiologic alteration under HRCT such as: pleural thickness, bronchiectasis, interstitial pattern, micro-nodules pattern, ground-glass opacity, and a reticular pattern. A logistic regression showed that methotrexate use, evolution of the disease (beta 0.018), and FEV1 (beta 0.89) were statistically associated with HRCT alterations. A projection of patients, free from event (HRCT lung scan altered), was obtained through a Kaplan–Meyer analysis, using FEV1 as a predictor over time. The curve shows that in the next 240 months (20 years) nearly 40% of the patients with rheumatoid arthritis will have FEV1 values less than 80% of the normal values predicted for the same age and sex. The FEV1 values have demonstrated a good correlation between PFT and HRCT lung scan. Therefore, they provide an accessible tool for tracking early pulmonary alterations. Methotrexate use and time evolution of the disease have been associated with altered FEV1.
Similar content being viewed by others
References
Gabriel SE (2001) The epidemiology of rheumatoid arthritis. Rheum Dis Clin North Am 27:269–282
Dugowson CE, Koepsell TD, Voigt LF, Bley L, Nelson JL, Daling JR (1991) Rheumatoid arthritis in women: incidence rates in group health cooperative, Seattle, Washington, 1987–1989. Arthritis Rheum 34:1502–1507
Turesson C, O Fallon WM, Crowson CS, Gabriel SH, Matteson EL (2002) Ocurrence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol 29:62–67
Lindqvist E, Saxne T, Geborek P, Eberhardt K (2002) Ten year outcome in a cohort of patients with early rheumatoid arthritis: health status, disease process, and damage. Ann Rheum Dis 61:1055–1059
Hochberg MC, Johnston SS, John AK (2008) The incidence and prevalence of extra-articular and systemic manifestations in a cohort of newly-diagnosed patients with rheumatoid arthritis between 199 and 2006. Curr Med Res Opin 24:469–480
Deighton CM, Walker DJ (1991) The familial nature of rheumatoid arthritis. Ann Rheum Dis 50:62–65
Heliovaara M, Aho K, Aromaa A, Knekt P, Reunanen A (1993) Smoking and risk of rheumatoid arthritis. J Rheumatol 20:1830–1835
Anaya JM, Diethelm L, Ortiz L et al (1995) Pulmonary involvement in rheumatoid arthritis. Semin Arthritis Rheum 24:242–254
Ellman P, Ball RE (1948) Rheumatoid disease with joint and pulmonary manifestations. Br Med J. 2:816–820
Mori S, Cho I, Koga Y, Sugimoto M (2008) Comparison of pulmonary abnormalities on high-resolution computed tomography in patients with early versus longstanding rheumatoid arthritis. J Rheumatol 35:1513–1521
Hakala M (1988) Poor prognosis in patients with rheumatoid arthritis hospitalized for interstitial lung fibrosis. Chest 93:114–118
Carotti M, Salaffi F, Manganelli P, Salvolini L, Bichi Secchi E, De Berardinis S (2001) The subclinical involvement of the lung in rheumatoid arthritis: evaluation by high-resolution computed tomography. Reumatismo 53:280–288
Zrour SH, Touzi M, Bejia I et al (2005) Correlations between high-resolution computed tomography of the chest and clinical function in patients with rheumatoid arthritis. Prospective study in 75 patients. Jt Bone Spine 72:41–47
Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324
Cardiel MH, Abello-Banfi M, Ruiz-Mercado R, Alarcon-Segovia D (1993) How to measure health status in rheumatoid arthritis in non-English speaking patients: validation of a Spanish versión of the Health Assessment Questionnaire Disability Index (Spanish HAQ-DI). Clin Exp Rheumatol 11:117–121
Fransen J, van Riel PLCM (2005) The disease activity score and the EULAR response criteria. Clin Exp Rheumatol 23(suppl.39):S93–S99
Chikura B, Lane S, Dawson JK (2009) Clinical expression of leflunomida-induced pneumonitis. Rheumatology 48:1065–1068
Gizinski AM, Mascolo M, Loucks JL et al (2009) Rheumatoid arthritis (RA)-specific autoantibodies in patients with interstitial lung disease and absence of clinically apparent articular RA. Clin Rheumatol 28:611–613
Tokuda H, Sakai F, Yamada H et al (2008) Clinical and radiological features of pneumocystis pneumonia in patients with rheumatoid arthritis, in comparison with methotrexate pneumonitis and Pneumocystis pneumonia in acquired immunodeficiency syndrome: a multicenter study. Intern Med 47:915–923
Tanaka N, Kim JS, Newell JD et al (2004) Rheumatoid arthritis-related lung diseases: CT findings. Radiology 232:81–91
Alarcon GS, Kremer J, Macaluso M, Weinblatt M, Cannon G, Palmer W et al (1997) Risk factors for methotrexate-induced lung injury in patients with rheumatoid arthritis. Ann Intern Med 127:356–364
Gochuico B, Avila N, Chow C, Novero L, Wu HP, Ren P et al (2008) Progressive preclinical interstitial lung disease in rheumatoid arthritis. Arch Intern Med 168:159–166
Kim E, Collard H, King Jr. T (2009) Rheumatoid arthritis-associated interstitial lung disease. The relevance of histopathologic and radiographic pattern. Chest 136:1397–1405
Lynch D, Travis W, Muller N, Galvin J, Hansell D (2005) Grenler Ph. Idiopathic interstitial pneumonias: CT features. Radiology 236:10–21
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Leonel, D., Lucia, C., A, M. et al. Pulmonary function test: its correlation with pulmonary high-resolution computed tomography in patients with rheumatoid arthritis. Rheumatol Int 32, 2111–2116 (2012). https://doi.org/10.1007/s00296-011-1933-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-011-1933-8