Interstitial lung disease and neuropathy as predominant extra-articular manifestations in patients with rheumatoid arthritis: a prospective study.
Anurag Bharadwaj, Nigil Haroon
Med Sci Monit 2005; 11(10): CR498-502
Available online: 2005-10-01
BACKGROUND: Rheumatoid arthritis (RA) patients with extra-articular manifestations(ExRA) have a severe course of the disease and higher mortality. Indian patients are considered to havea low prevalence of ExRA. We prospectively assessed ExRA in patients with rheumatoid arthritis from southernIndia. MATERIAL/METHODS: 140 RA patients were qualified for the study. Patients with confounding factorswere excluded. A detailed history and clinical examination was performed. Two independent investigatorsmade a thorough search with relevant investigations for ExRA, according to well-defined criteria. RESULTS:At least one ExRA was present in 36 patients (25.7%). The predominant ExRA (9.29%) was Interstitial LungDisease (ILD). 12 patients had neuropathy (8.57%). 5 patients had eye involvement, while 3 had cutaneousvasculitis. 4 patients had rheumatoid nodules, and 1 had amyloidosis. The median age at diagnosis andduration of disease were significantly higher in patients with ExRAs than in those without. Deformitiesand the use of steroids were more common in the ExRA cohort. CONCLUSIONS: The present study shows a highprevalence of ILD and neuropathy as ExRAs in our population. A more extensive investigative protocolis warranted for picking up milder presentations of these serious manifestations.
Keywords: Arthritis, Rheumatoid - physiopathology, Adult, Confounding Factors (Epidemiology), Joint Diseases - physiopathology, Lung Diseases, Interstitial - physiopathology, Peripheral Nervous System Diseases - physiopathology, Prospective Studies