Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis.

Abstract : The characteristics of patients with rheumatoid arthritis (RA) who develop obliterative bronchiolitis characterised by severe airflow obstruction have been hitherto poorly investigated. A retrospective study of 25 patients with RA and functional evidence of obliterative bronchiolitis (forced expiratory volume in one second (FEV(1))/forced vital capacity (FVC) <50% and/or residual volume (RV)/total lung capacity (TLC) >140% predicted) was conducted. Patients (mean+/-SD age 64+/-11 yrs) included 17 never-smokers and eight ex-smokers (10.5+/-5.4 pack-yrs). The diagnosis of RA preceded respiratory symptoms in 88% of cases. Dyspnoea on exertion was present in all patients and bronchorrhea in 44%. High-resolution computed tomography findings included: bronchial wall thickening (96%), bronchiectasis (40%), mosaic pattern (40%), centrilobular emphysema (56%), and reticular and/or ground-glass opacities (32%). Pulmonary function tests showed: FEV(1) 41+/-12% pred, FEV(1)/FVC 49+/-14%, FVC 70+/-20% pred, RV 148+/-68% pred and RV/TLC 142+/-34% pred. Lung biopsy, available in nine patients, demonstrated constrictive, follicular and mixed bronchiolitis. Patients were followed for 48.2+/-49 months. Treatment was poorly effective. Chronic respiratory failure occurred in 40% of patients, and four patients died. Obliterative bronchiolitis associated with rheumatoid arthritis is a severe and under-recognised condition leading to respiratory failure and death in a high proportion of patients.
Type de document :
Article dans une revue
European Respiratory Journal, European Respiratory Society, 2009, 33 (5), pp.1053-61. 〈10.1183/09031936.00091608〉
Liste complète des métadonnées

http://hal.univ-brest.fr/hal-00922939
Contributeur : Ghislaine Calvez <>
Soumis le : mardi 31 décembre 2013 - 15:56:21
Dernière modification le : jeudi 8 février 2018 - 16:38:01

Lien texte intégral

Identifiants

Collections

Citation

G. Devouassoux, V. Cottin, H. Lioté, E. Marchand, I. Frachon, et al.. Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis.. European Respiratory Journal, European Respiratory Society, 2009, 33 (5), pp.1053-61. 〈10.1183/09031936.00091608〉. 〈hal-00922939〉

Partager

Métriques

Consultations de la notice

79