Bronchial obstruction in patients with rheumatoid arthritis

Aim. To estimate the incidence of bronchial obstruction (BO) in patients with rheumatoid arthritis (RA) and BO comorbidity with respiratory symptoms and structural alterations of the lower respiratory tract (LRT) by findings of multislice computer tomography (MCT) of the lungs.
Material and methods. Clinical examination, spirometry, body plethysmography, MCT of the lungs were made in 104 non-smokers with RA and 100 patients free of RA and chronic respiratory diseases.
Results. Incompletely reversible generalized BO was diagnosed in 19(18%), distal bronchial obstruction in 27(26%) patients.Bronchial permeability weakly correlated with severity of respiratory symptoms. BO was associated in RA patients with structural changes in LRT as shown by MCT of the lungs: thicker wall and irregular lumen of the visual bronchi, the presence of bronchoectases and signs of bronchiolith. Structural changes of LRT were detected by MCT of the lungs in 57(55%) RA patients.
Conclusion. RA patients often develop incompletely reversible BO with microsymptoms probably due to diffuse deforming lesion of the LRT. BO in RA progresses because of LRT rheumatoid lesion extention to bronchioles. RA patients' external respiratory function should be regularly examined with conduction of MCT in detection of ventilatory disorders.

rheumatoid arthritis, respiratory affection, bronchial obstruction, multislice computer tomography