Distal bronchial tubes damage in patients with rheumatoid arthritis

Abstract

Objective. To study prevalence and clinical picture of distal parts of bronchial tree(bronchiolitis) in pts with rheumatoid arthritis (RA). Material and methods. 104 nonsmoking pts with RA and 100 pts without RA and chronic diseases of respiratory apparatus were included. General clinical examination, spirometry, bodyplethysmography, examination of lung diffusion capacity (LDC) and multispiralcomputed tomography (MSCT) of lungs were performed. Results. Direct and indirect bronchiolitis signs were revealed with MSCT in 36 (35%) ptswith RA and 1 pt of control group (p<0,01). Pts with signs of bronchiolitis complained of shortness of breath (69% of pts), cough (56%), phlegm discharge (56%), heavy breathing (25%). Obstructive lung ventilation disturbances were revealed in 19 (53%) RA pts with bronchiolitis. Restrictive disturbances and LDC decrease were present in 3 (8%) pts. High frequency of oligosymptomatic bronchiolitis course was found in RA pts. Bronchiolitis symptoms in RA pts coincided with signs of proximal bronchial tubes damage forming picture of diffuse damage of bronchial tree. Conclusion. Bronchiolitis is a prevalent variant of respiratory apparatus damage in pts with RA. Pts with MSCT signs of bronchiolitis often have cough, phlegm discharge, shortness of breath, heavy breathing. Lung ventilation disturbances of obstructive type are common but part of pts has normal lung functional measures or restriction. Oligosymptomatic forms of distal bronchial tubes damage are prevalent in RA pts. Lung MSCT is the main method of bronchiolitis diagnostics because bronchiolitis induces nonspecific clinical signs and RA pts have multilevel respiratory apparatus damage. MSCT reveals signs of distal bronchial tubes damage in 35% of RA pts.