Pulmonary dysfunction in rheumatoid disease

During an investigation of pulmonary dysfunction in 41 consecutive patients with classical or definite rheumatoid arthritis, it was found that 41.4 percent had abnormalities of pulmonary diffusion. Generally the physiologic profile was one of decreased vital capacity, decreased total lung capacity, and arterial hypoxemia; these abnormalities were supported by the pathologic findings of percutaneous lung biopsy. All patients showed changes of interstitial fibrosis. Usually, the patients were not symptomatic, and 47.0 percent had normal chest roentgenograms. The type of treatment received, level of rheumatoid factor, duration of disease, and American Rheumatism Association (ARA) stage of disease failed to correlate with the presence or absence of pulmonary dysfuntion. The clinical significance of pulmonary fibrosis in rheumatoid patients is unknown, and the disease seems to be mild clinically and only slowly progressive. It is concluded that pulmonary fibrosis is common in rheumatoid disease and should be regarded as an expected manifestation, rather than an unusual complication, of the systemic process connoted by the term rheumatoid disease.