HIGH-RESOLUTION COMPUTED-TOMOGRAPHY OF THE LUNG IN LIFELONG NONSMOKING PATIENTS WITH RHEUMATOID-ARTHRITIS

被引:80
作者
HASSAN, WU
KEANEY, NP
HOLLAND, CD
KELLY, CA
机构
[1] ROYAL INFIRM,SUNDERLAND SR2 7JE,DURHAM,ENGLAND
[2] QUEEN ELIZABETH HOSP,GATESHEAD NE9 6SX,ENGLAND
关键词
D O I
10.1136/ard.54.4.308
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives-To define pulmonary involvement on high resolution computed tomography (HRCT) of the thorax in lifelong non-smoking rheumatoid arthritis patients and to relate the results to pulmonary function, bronchial reactivity, and a variety of clinical and serological factors . Methods-Twenty lifelong non-smoking RA patients (mean age 59 years (range 44-72; 18 females) were studied. Detailed medical and drug histories were taken, Protease inhibitor phenotype (Pi) and HLA-DR4 status were assessed. Schirmer's tear tests were performed to detect keratoconjunctivitis sicca (KCS). Spirometry, flow volume loops, and gas factor measurement were The degree of bronchial reactivity (PC20 FEV(1)) was measured by a methacholine inhalation test. Chest and hand radiographs and HRCT of the lung were performed in all patients. Results-Thirteen patients were HLA-DR4 positive. Eighteen had the Pi MM and two the Pi MS phenotype. Eight patients had evidence of KCS on Schirmer's tear testing. Ten patients achieved PC20 FEV(1) in the methacholine inhalation test. All the patients had normal chest radiographs and all showed evidence of erosive arthropathy on hand radiographs. Five patients (25%) showed basal bronchiectasis and one mild interstitial lung disease on HRCT. All five patients with bronchiectasis had the Pi MM phenotype, four had HLA-DR4, four had KCS and three achieved PC20 FEV(1); these values were not significantly different (p>0.05) from those in patients without bronchiectasis. Conclusion-Using the highly sensitive technique of HRCT, we found evidence to suggest that the incidence of bronchiectasis lifelong non-smoking RA may be much higher than previously reported.
引用
收藏
页码:308 / 310
页数:3
相关论文
共 14 条
[1]  
FEWINS HE, 1991, BRIT J RHEUMATOL, V30, P214
[2]   BRONCHIAL HYPERRESPONSIVENESS TO METHACHOLINE IN PATIENTS WITH PRIMARY SJOGRENS-SYNDROME [J].
GUDBJORNSSON, B ;
HEDENSTROM, H ;
STALENHEIM, G ;
HALLGREN, R .
ANNALS OF THE RHEUMATIC DISEASES, 1991, 50 (01) :36-40
[3]  
HANSELL DM, 1993, ROY SOC MED, V3, P67
[4]   BRONCHIAL REACTIVITY AND AIR-FLOW OBSTRUCTION IN RHEUMATOID-ARTHRITIS [J].
HASSAN, WU ;
KEANEY, NP ;
HOLLAND, CD ;
KELLY, CA .
ANNALS OF THE RHEUMATIC DISEASES, 1994, 53 (08) :511-514
[5]  
HILLARBY MC, 1993, BRIT J RHEUMATOL, V32, P794
[6]   LUNG-FUNCTION IN PRIMARY SJOGRENS-SYNDROME - A CROSS-SECTIONAL AND LONGITUDINAL-STUDY [J].
KELLY, C ;
GARDINER, P ;
PAL, B ;
GRIFFITHS, I .
THORAX, 1991, 46 (03) :180-183
[7]  
KELLY CA, 1993, BAILLIERE CLIN RHEUM, V7, P30
[8]  
MCDONAGH J, 1994, BRIT J RHEUMATOL, V33, P118
[9]   BRONCHIECTASIS AND RHEUMATOID-ARTHRITIS - A CLINICAL-STUDY [J].
MCMAHON, MJ ;
SWINSON, DR ;
SHETTAR, S ;
WOLSTENHOLME, R ;
CHATTOPADHYAY, C ;
SMITH, P ;
JOHNS, P ;
CROSBY, NH .
ANNALS OF THE RHEUMATIC DISEASES, 1993, 52 (11) :776-779
[10]   RHEUMATOID-ARTHRITIS AND SMALL AIRWAYS FUNCTION - EFFECTS OF DISEASE-ACTIVITY, SMOKING, AND ALPHA-1-ANTITRYPSIN DEFICIENCY [J].
MOUNTZ, JD ;
TURNER, RA ;
COLLINS, RL ;
GALLUP, KR ;
SEMBLE, EL .
ARTHRITIS AND RHEUMATISM, 1984, 27 (07) :728-736