Abstract
AbstractThe prevalence of laryngeal involvement in Rheumatoid Arthritis (RA) ranges from 13 to 75%. The specific RA manifestations include the cricoarytenoid arthritis and the presence of rheumatoid nodules in the vocal folds. ObjectiveThe objective of this study is to evaluate the prevalence of dysphonia and laryngeal alterations on videolaryngoscopy in RA patients and their association with disease activity. MethodThis is a clinical cross-sectional study that evaluated patients with rheumatoid arthritis as to their disease activity score in 28 joints (DAS-28), laryngeal symptoms, application of a Portuguese version of the Voice Handicap Index and videolaryngoscopy findings, comparing them with a control group. ResultsWe evaluated 47 (54%) patients with rheumatoid arthritis and 40 (46%) controls. The prevalence of dysphonia and videolaryngoscopy changes was respectively 12.8% and 72.4% in patients with RA. The mean of DAS-28 was 3.3 ± 1.2; 26 (74.3%) of 35 patients presenting active disease had laryngeal changes (p = 0.713). Posterior laryngitis was the most common diagnosis (44.7%). ConclusionThe prevalence of laryngeal disorders in RA patients was 72.4% and the prevalence of dysphonia was 12.8%. There was no significant relationship between laryngeal disorders and disease activity.
Highlights
Rheumatoid arthritis (RA) is a chronic, autoimmune disease, of unknown cause, which affects mainly women between 30 and 50 years of age[1,2]
Paper submitted to the BJORL-SGP (Publishing Management System - Brazilian Journal of Otorhinolaryngology) on November 6, 2012; and accepted on January 11, 2013. cod. 10561
Knowledge on the laryngeal involvement in RA patients is longstanding: the changes were described by Mackenzie, in 1880, by means of studies in cadavers, and the first studies using laryngoscopy happened in 19606
Summary
Rheumatoid arthritis (RA) is a chronic, autoimmune disease, of unknown cause, which affects mainly women between 30 and 50 years of age[1,2]. RA represents joint manifestations as well as extra-joint manifestations, which may potentially happen to any diarthrodial joint, including the cricoarythenoid[4]. The prevalence of laryngeal repercussions in RA is 13% to 75%5,6 in different studies and, in post-mortem studies, which is of 45% to 88%6. Knowledge on the laryngeal involvement in RA patients is longstanding: the changes were described by Mackenzie, in 1880, by means of studies in cadavers, and the first studies using laryngoscopy happened in 19606. Laryngeal manifestations in RA patients are usually subclinical[5] and benign[6]. Afterwards, patients experience odynophagia, sore throat, cough and dyspnea[5]. Dysphonia happens to 12% to 27% of the patients with RA, and the relative risk of dysphonia varies between 3 and 4 when compared to healthy patients[7]
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