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Changes in bronchoalveolar lavage and lung function in rheumatoid arthritis. A controlled study
R J Barapatre1, L C Prabhakaran, R U Rupwate
1Department of Respiratory Medicine, Seth GS Medical College, Bombay.
The Journal of the Association of Physicians of India
|August 1, 1990
Summary
Bronchoalveolar lavage in rheumatoid arthritis patients revealed lung abnormalities, including increased polymorphs and lymphocytes, even without clinical symptoms. These findings suggest potential lung involvement in rheumatoid arthritis patients.
Area of Science:
- Pulmonary Medicine
- Rheumatology
- Immunology
Background:
- Rheumatoid arthritis (RA) is a systemic autoimmune disease primarily affecting joints.
- Lung involvement is a known extra-articular manifestation of RA, but its subclinical detection requires further investigation.
- Bronchoalveolar lavage (BAL) is a diagnostic tool that can provide insights into inflammatory processes within the lungs.
Purpose of the Study:
- To compare bronchoalveolar lavage findings in patients with chronic rheumatoid arthritis and healthy controls.
- To identify specific cellular changes in BAL fluid associated with rheumatoid arthritis.
- To explore the relationship between BAL abnormalities, clinical lung disease, and radiographic findings in RA patients.
Main Methods:
- A comparative study involving 30 patients with chronic rheumatoid arthritis and 30 age-matched controls.
- Bronchoalveolar lavage was performed on all participants.
- BAL fluid analysis included cell counts and differential analysis, comparing findings between RA patient subgroups (clinical lung disease, BAL changes, no abnormalities) and controls.
Main Results:
- Bronchoalveolar lavage in RA patients showed increased percentages of polymorphs (10.3%) in those with clinical lung disease and lymphocytes (14.5%) in those with BAL changes, compared to controls (polymorphs 1.9%, lymphocytes 5.2%).
- RA factor positivity did not differ significantly across RA patient subgroups.
- Abnormalities in BAL fluid can occur independently of, or in conjunction with, radiographic and functional lung abnormalities in chronic rheumatoid arthritis.
Conclusions:
- Bronchoalveolar lavage can detect pulmonary inflammation in rheumatoid arthritis patients, sometimes in the absence of overt clinical or radiographic signs of lung disease.
- Increased polymorphonuclear leukocytes and lymphocytes in BAL fluid are potential indicators of lung involvement in RA.
- BAL analysis is a valuable tool for assessing subclinical lung disease in rheumatoid arthritis, aiding in a comprehensive understanding of the disease's systemic impact.