Clinical, spirometric and radiological characteristics of Brazilian rheumatoid arthritis patients

Rheumatoid Arthritis (RA) is a common inflammatory disease, and pulmonary involvement is usual. An algorithm has been proposed for evaluation and management of RA patients with suspected interstitial lung disease, based on chest radiograph, physical examination and symptoms (Kim, E.J. et al. Chest 2009;136:1397-1405). Objective: To describe clinical, spirometric and radiological characteristics of Brazilian RA patients using low-cost evaluation. Methods: Patients with RA, irrespective of having pulmonary involvement, were evaluated, and data regarding pulse oximetry, spirometric measures and digital chest radiograph were obtained. Results: 248 RA patients were analyzed. 85% were female, mean age was 56±10 years, median disease onset time was 16 years (IQR 7,75-24). The most common exposition was mold (22%). 50% had no smoking history, 17% were current smokers and 33% were former smokers. Pulse oximetry was normal (above 94%) in 87%. MRC dyspnea index 1 or 2 were observed in 50% and 32%, respectively. Most commonly used drugs were Methotrexate (92%), Prednisone (80%) and Chloroquine (78%). Spirometry was classified as normal (70%), obstructive (11%), restrictive (11%), mixed (5%) and unspecified (3%) patterns. At the moment, data for chest radiograph is available for 71 patients (29%), parenchymal abnormalities were observed in 56%, mainly linear (38%) and reticular opacities (18%). Conclusion: This is the first study in Brazilian RA patients to analyze digital chest radiographs and to evaluate lung abnormalities. Spirometric alterations are common in RA patients. Abnormalities in digital chest radiographs were more frequent than previously described in convencional radiographs.