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Abstract
THE FREQUENCY OF PULMONARY MANIFESTATIONS OF RHEUMATOID ARTHRITIS PATIENTS IN MOSUL, IRAQ
*Dr. Marwah Mahfoodh Shakir, Dr. Rami Mohammed Adil Al-Hayali and Dr. Sara Nassear Hassan
ABSTRACT
Background: Rheumatoid arthritis (RA) is a chronic, inflammatory disease affecting synovial joints, leading to joint deformities and destruction. Pulmonary involvement is a significant extra-articular manifestation, contributing to morbidity and mortality. RA is more common in women and men with long-standing RA, positive rheumatoid factor, and subcutaneous nodules. Aim: To assess the frequency of pulmonary involvement of RA. Patients and Methods: A case series study was conducted at Ibn-Sina Teaching Hospital in Mosul and two private clinics, one specializing in rheumatology and the other in respiratory medicine, from January to December 2020. The study included 75 patients diagnosed with rheumatoid arthritis, including 12 males and 63 females. The study excluded patients with confirmed or suspected COVID-19 due to difficulty in distinguishing radiological findings from pulmonary manifestations of the disease. Results: The study found that 84.6% of patients with rheumatoid arthritis (RA) had pulmonary manifestations, including rheumatoid arthritis-interstitial lung disease (RA-ILD) in 23.1% of patients, rheumatoid nodules in 7.69%, pleural effusion in 1.28%), and bronchiectasis in 1.28%). Patients with RA-ILD had a higher proportion of males (23.1%) and were older (mean age of 56.7 years) than those without pulmonary manifestations (46.7 years). Patients with pulmonary manifestations were more likely to be smokers (34.6% versus 7.7%). Four patients (15.3%) had no clinical or spirometric abnormality, and the diagnosis was made on imaging. The study highlights the importance of understanding the pulmonary manifestations of RA in managing the disease. Conclusion: The study concluded that about one-third of RA patients had pulmonary manifestations. RA Patients with pulmonary manifestations are more likely to be males and smokers than RA patients without pulmonary manifestations.
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