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Pulmonary involvement in ankylosing spondylitis.

Percival D Sampaio-Barros1, Elza Maria F P Cerqueira, Sílvio M Rezende

  • 1Unit of Rheumatology, Department of Internal Medicine, State University of Campinas Faculty of Medical Sciences (FCM / UNICAMP), Barão Geraldo, Campinas SP, CEP 13081-970, Brazil. psbarros@fcm.unicamp.br

Clinical Rheumatology
|March 31, 2006
PubMed
Summary

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Ankylosing spondylitis (AS) patients frequently show subclinical lung issues. Pulmonary function tests and imaging reveal abnormalities in many, often linked to spinal disease and smoking.

Area of Science:

  • Pulmonary Medicine
  • Rheumatology
  • Radiology

Background:

  • Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
  • Pulmonary complications in AS are not well-characterized, especially in asymptomatic patients.

Purpose of the Study:

  • To investigate the prevalence and patterns of subclinical pulmonary involvement in asymptomatic patients with ankylosing spondylitis.
  • To identify factors associated with pulmonary abnormalities in this cohort.

Main Methods:

  • Prospective study of 52 asymptomatic AS patients.
  • Pulmonary assessment included plain chest radiography, pulmonary function tests (PFTs), and thoracic high-resolution computed tomography (HRCT).
  • Data analyzed for associations with sex, race, spinal involvement, thoracic diameter, smoking, and HLA-B27.

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Main Results:

  • 40% of patients had HRCT abnormalities, including linear opacities (19%), lymphadenopathy (12%), emphysema (10%), and bronchiectasis (8%).
  • 52% of patients exhibited a restrictive pattern on PFTs.
  • Linear opacities correlated with smoking history and dorsal spine involvement. Lower thoracic diameter was linked to spinal disease and restrictive PFT patterns.

Conclusions:

  • Subclinical pulmonary involvement is common in asymptomatic ankylosing spondylitis patients.
  • HRCT and PFTs can detect these abnormalities, which may be associated with disease severity and smoking status.