Asymptomatic pulmonary involvement in RA

Abstract

Other studies had shown a high prevalence of FA, even in recent onset RA. 3 We have recently investigated the presence of pulmonary disease in 24 consecutive patients with RA without respiratory symptoms or signs and a normal chest radiograph. In all these patients we performed a chest HRCT scan as well as complete pulmonary function tests (PFTs). Our patients were predominantly women (22/24), of mean age 49.4 years (range 26-72), and 46% of them had a disease duration of less than 2 years. Only 33.3% were current smokers. We found TLCO of <75% in 50% of the patients; two patients had obstructive PFT and one patient restrictive PFT. Pleuro-pulmonary alterations were detected in 20.8% of the patients on the HRCT scan, but only one patient had an HRCT pattern suggestive of FA according to stringent criteria. 2 In all the other patients the alterations observed were mild and non-specific (pleural abnormalities, septal and non-septal lines, micronodules). Our data confirm a rather high prevalence of pleuropulmo-nary alterations in patients with RA, even in the absence of respiratory symptoms. However, we found evidence of FA much less frequently than Dawson et al.