Document Detail


Pulmonary functions testing in patients with rheumatoid arthritis.
MedLine Citation:
PMID:  19432035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A high incidence of abnormal pulmonary function tests has been reported in cross-sectional studies among patients with rheumatoid arthritis. Few patients have been enrolled in longitudinal studies. OBJECTIVES: To perform PFT in rheumatoid arthritic patients without pulmonary involvement and to identify variables related to changes in PFT over 5 years of follow-up. METHODS: Consecutive RA patients underwent PFT according to recommendations of the American Thoracic Society. All surviving patients were advised to repeat the examination 5 years later. RESULTS: PFT was performed in 82 patients (21 men, 61 women). Their mean age was 55.7 (15.9) years and the mean RA duration was 11.1 (10) years. Five years later 15 patients (18.3%) had died. Among the 67 surviving patients, 38 (56.7%) agreed to participate in a follow-up study. The initial PFT revealed normal PFT in only 30 patients (36.6%); an obstructive ventilatory defect in 2 (2.4%), a small airway defect in 12 (17%), a restrictive ventilatory defect in 21 (25.6%), and reduced DLco in 17 (20.7%). Among the 38 patients participating in the 5 year follow-up study, 8 developed respiratory symptoms, one patient had a new obstructive ventilatory defect, one patient developed a restrictive ventilatory defect, and 5 patients had a newly developed small airway defect. The DLco had improved in 7 of the 8 patients who initially had reduced DLco, reaching normal values in 5 patients. Over the study period a new reduction in DLco was observed in 7 patients. Linear regression analyses failed to identify any patient or disease-specific characteristics that could predict a worsening in PFT. The absolute yearly decline in forced expiratory volume in 1 sec among our RA patients was 47 ml/year, a decline similar to that seen among current smokers. CONCLUSIONS: Serial PFT among patients with RA is indicated and allows for earlier identification of various ventilatory defects. Small airways disturbance was a common finding in our RA patients.
Authors:
Lone S Avnon; Fauaz Manzur; Arkadi Bolotin; Dov Heimer; Daniel Flusser; Dan Buskila; Shaul Sukenik; Mahmoud Abu-Shakra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  11     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-05-12     Completed Date:  2009-05-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  83-7     Citation Subset:  IM    
Affiliation:
Pulmonary Clinic, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / complications,  drug therapy,  physiopathology*
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Lung Diseases / diagnosis,  epidemiology*,  physiopathology
Lung Volume Measurements
Male
Middle Aged
Pulmonary Diffusing Capacity / physiology
Pulmonary Ventilation / physiology*
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Antirheumatic Agents

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