A Study of Pulmonary Manifestations in Patients of Rheumatoid Arthritis Attending a Tertiary Care Centre in Kumaon Region of Uttrakhand

Background: ILD is the most common pulmonary manifestation of rheumatoid arthritis and rheumatoid arthritis is most common encountered connective tissue disorder. Lung affliction directly implicated with the underlying RA is more frequent, although pulmonary infection and drug toxicity are common complications of RA. The lung is involved in rheumatoid disease because of the abundant vasculature and connective tissue. RA is involved in variable amounts of pathological inflammation and fibrosis of the lungs. The well-characterized pulmonary disorders in RA include: RA-associated interstitial lung disease, pleural effusions and pleuritis, rheumatoid nodules, Caplans syndrome, pulmonary vasculitis and pulmonary airway involvement. Bronchiectasis and an increased incidence of chest infections have also been reported. Methods: Patients of Rheumatoid arthritis patients above 16years of age attending the Department of Medicine in Government Medical College & Associated Dr. Susheela Tiwari Govt Hospital, Haldwani (NAINITAL). Results: Out of the102 patients recruited, 72(70.5%) were female and 30 (29.41%) were male. Majority were in age group of (55-64) .102 patients who underwent this test 63 (61.76 %) were found to have abnormalities while 39 (38.23%) were normal. Out of the 63 patients with abnormalities, 28(27.4%) had Obstructive ventilatory defects, 35(34.3%) had Restrictive ventilatory defect. The commonest symptom was in Cough at (41.7%) followed by Phlegm in (22.54%) and increased frequency of chest colds and chest illnesses in a year in (14.20%) Breathlessness in (10.78%) Wheeze in (9%). ( 52.90% ) patients had duration > 5 ys of duration suffering from rheumatoid arthritis .Rheumatoid factor was positive in 74 (72.54%). The ESR median value of 36.1 had abnormal spirometry compared with those at 11 who had normal (p=0.001). Conclusion: In our study older age, positive rheumatoid factor, and those with a high ESR were more likely to have abnormalities in their pulmonary function test.