Pulmonary Manifestations in Patients With Rheumatoid Arthritis Presenting With Respiratory Symptoms at a Tertiary Care Center in Central India: A Cross-Sectional Study.
- 1Medical Education, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, IND.
- 2Medicine, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, IND.
- 3Rheumatology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, IND.
Abstract
Background
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that, beyond its classical articular manifestations, frequently involves the lungs. Pulmonary complications, including interstitial lung disease (ILD), pleural disease, airway disease, and pulmonary vascular involvement, are important extra-articular manifestations that contribute substantially to disease morbidity. Many affected patients, however, remain clinically asymptomatic despite radiological or functional abnormalities.Objectives
The primary objective was to characterize the clinical, functional, and radiological pulmonary findings among patients with RA presenting with respiratory symptoms. The secondary objective was to assess the association of pulmonary function test (PFT) and high-resolution computed tomography (HRCT) abnormalities with disease duration and six-minute walk test (6MWT) distance.Methods
This cross-sectional observational study was conducted in the Department of General Medicine at a tertiary care, research, and teaching institute over two years (August 2024 to August 2026). Sixty-five consecutive patients aged >18 years with RA diagnosed according to the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) classification criteria and presenting with respiratory symptoms were enrolled by convenience sampling after excluding patients with pre-existing pulmonary disease or a connective tissue disorder other than RA. All patients underwent hematological and serological investigations, a 6MWT, spirometry, chest radiography, and HRCT of the chest. Disease activity was assessed using the Disease Activity Score-28 (DAS-28). Unadjusted associations were assessed using the chi-square test, with p < 0.05 considered statistically significant.Results
Females constituted 72.3% (47/65) of the cohort, and the 41-60-year age group accounted for more than half of the participants (35/65, 53.8%). The mean duration of RA at presentation was 7.1 ± 3.79 years. Chronic cough (43/65, 66.2%) and exertional dyspnea (30/65, 46.1%) were the most common respiratory symptoms, although 46% of patients (30/65) had no abnormal findings on chest auscultation. A restrictive pattern was the most common PFT abnormality (33/65, 50.8%), while a usual interstitial pneumonia (UIP) pattern was the most common abnormal HRCT finding (14/65, 21.5%). Longer disease duration was significantly associated with abnormal PFT findings (χ² = 7.98, df = 3, p = 0.047) and abnormal HRCT findings (χ² = 9.89, df = 3, p = 0.02). Shorter 6MWT distance was significantly associated with abnormal PFT findings (χ² = 20.43, df = 2, p < 0.001) and abnormal HRCT findings (χ² = 10.95, df = 2, p = 0.004).Conclusion
In this single-center sample of patients with RA presenting with respiratory symptoms, PFT and HRCT abnormalities were common, and longer disease duration and shorter 6MWT distance were associated with abnormal PFT and HRCT findings. These unadjusted cross-sectional associations do not establish causation or predictive value, and the findings cannot be used to estimate the prevalence of pulmonary involvement among all patients with RA. Prospective studies with adjustment for potential confounders are needed.
Related
- OA26 Anti-NXP2-Positive Juvenile Dermatomyositis in an Adolescent Following a Five-Year History of Childhood Cutaneous Manifestations, Presenting with Severe Myositis, Bulbar Weakness and Respiratory Failure Complicated by Macrophage Activation Syndrome
- A Rare Case of Cystic Bronchiectasis With Concurrent Pulmonary Aspergillosis in a Rheumatoid Arthritis Patient Receiving Etanercept.
- The effect of symptomatic extra-articular manifestations of rheumatoid arthritis on disease activity and patient-reported outcomes: a cross-sectional and observational study.
- Intravascular large B-cell lymphoma presenting as unilateral lymphedema in a patient with rheumatoid arthritis and sarcoidosis : A case report
- Systemic Sclerosis Presenting With Long-Standing Peripheral Neuropathy and Delayed Multisystem Manifestations: A Case Report
BibTeX
@article{sanjay2026pulmonary,
title = {{Pulmonary Manifestations in Patients With Rheumatoid Arthritis Presenting With Respiratory Symptoms at a Tertiary Care Center in Central India: A Cross-Sectional Study.}},
author = {Samruddhi Sanjay and Nalini Humaney and Salil Ganu and Fahad Idrees Shaikh},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117359},
url = {https://europepmc.org/article/MED/42968861},
note = {CC BY},
}
RIS
TY - JOUR
TI - Pulmonary Manifestations in Patients With Rheumatoid Arthritis Presenting With Respiratory Symptoms at a Tertiary Care Center in Central India: A Cross-Sectional Study.
AU - Samruddhi Sanjay
AU - Nalini Humaney
AU - Salil Ganu
AU - Fahad Idrees Shaikh
PY - 2026
DA - 2026/10/02
JO - Cureus
DO - 10.7759/cureus.117359
UR - https://europepmc.org/article/MED/42968861
AB - Background Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that, beyond its classical articular manifestations, frequently involves the lungs. Pulmonary complications, including interstitial lung disease (ILD), pleural disease, airway disease, and pulmonary vascular involvement, are important extra-articular manifestations that contribute substantially to disease morbidity. Many affected patients, however, remain clinically asymptomatic despite radiological or functional abnormalities.Objectives The primary objective was to characterize the clinical, functional, and radiological pulmonary findings among patients with RA presenting with respiratory symptoms. The secondary objective was to assess the association of pulmonary function test (PFT) and high-resolution computed tomography (HRCT) abnormalities with disease duration and six-minute walk test (6MWT) distance.Methods This cross-sectional observational study was conducted in the Department of General Medicine at a tertiary care, research, and teaching institute over two years (August 2024 to August 2026). Sixty-five consecutive patients aged >18 years with RA diagnosed according to the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) classification criteria and presenting with respiratory symptoms were enrolled by convenience sampling after excluding patients with pre-existing pulmonary disease or a connective tissue disorder other than RA. All patients underwent hematological and serological investigations, a 6MWT, spirometry, chest radiography, and HRCT of the chest. Disease activity was assessed using the Disease Activity Score-28 (DAS-28). Unadjusted associations were assessed using the chi-square test, with p < 0.05 considered statistically significant.Results Females constituted 72.3% (47/65) of the cohort, and the 41-60-year age group accounted for more than half of the participants (35/65, 53.8%). The mean duration of RA at presentation was 7.1 ± 3.79 years. Chronic cough (43/65, 66.2%) and exertional dyspnea (30/65, 46.1%) were the most common respiratory symptoms, although 46% of patients (30/65) had no abnormal findings on chest auscultation. A restrictive pattern was the most common PFT abnormality (33/65, 50.8%), while a usual interstitial pneumonia (UIP) pattern was the most common abnormal HRCT finding (14/65, 21.5%). Longer disease duration was significantly associated with abnormal PFT findings (χ² = 7.98, df = 3, p = 0.047) and abnormal HRCT findings (χ² = 9.89, df = 3, p = 0.02). Shorter 6MWT distance was significantly associated with abnormal PFT findings (χ² = 20.43, df = 2, p < 0.001) and abnormal HRCT findings (χ² = 10.95, df = 2, p = 0.004).Conclusion In this single-center sample of patients with RA presenting with respiratory symptoms, PFT and HRCT abnormalities were common, and longer disease duration and shorter 6MWT distance were associated with abnormal PFT and HRCT findings. These unadjusted cross-sectional associations do not establish causation or predictive value, and the findings cannot be used to estimate the prevalence of pulmonary involvement among all patients with RA. Prospective studies with adjustment for potential confounders are needed.
SN - 2168-8184
ER -