Pulmonary Manifestations in Patients with Rheumatoid Arthritis Visiting Mardan Medical Complex Mardan, kpk

¹Dr. Nabi Rahman, ²Dr. Hamidullah, ³Dr. Qasim Nawaz, ⁴Dr. Amjad Ali, ⁵Dr. Muhammad Qasim
Khan, ⁶Dr. Shah Muhammad Khan

¹Assistant Professor, Bacha Khan Medical College, Mardan Medical Complex, Mardan
²Assistant Professor, Bacha Khan Medical College, Mardan, Medicine Department, FCPS Medicine
³Assistant Professor Pulmonology, Gajju Khan Complex, Swabi
⁴Professor of Medicine, BKMC/MMC, Mardan
⁵Professor of Paediatrics, BKMC/MMC, Mardan
⁶Professor of Pharmacology, Rai Foundation Medical College, Sargodha
Corresponding Author: Dr. Hamidullah
Assistant Professor, Bacha Khan Medical College, Mardan, Medicine Department, FCPS Medicine

Abstract
Background:
Rheumatoid arthritis (RA) often causes pulmonary symptoms, which are often overlooked yet greatly
increase patient morbidity and death.
Objective:
To determine the frequency and types of pulmonary manifestations in patients with RA attending a Mardan
Medical Complex Mardan, kpk.
Methodology:
This cross-sectional observational study was conducted at the Rheumatology and Pulmonology
Departments of Mardan Medical Complex, Pakistan, from January to December 2023. The study used
nonprobability convenience sampling to recruit 218 RA patients who met the ACR/EULAR 2010 criteria.
Patients with lung issues linked to smoking or non-RA-related lung illnesses were not included. Clinical
assessment, chest X-rays, pulmonary function tests, and high-resolution computed tomography (HRCT)
where necessary were used to gather data. Demographic and clinical variables were described using descriptive statistics, and the Chi-square test was used to evaluate the relationships between pulmonary
involvement and clinical parameters; a p-value of less than 0.05 was deemed significant.
Results:
Of the 218 patients, the majority (39.45%) were between the ages of 46 and 60, and 71.56% were female.
Of the patients, 50.46% had pulmonary symptoms. The most frequent symptom was interstitial lung disease
(ILD) (22.02%), which was followed by methotrexate-induced pneumonitis (3.21%), pleural effusion
(9.63%), pulmonary nodules (6.42%), bronchiolitis (5.05%), and pulmonary hypertension (4.13%). Age
group (p = 0.041) and RA duration (p = 0.005) were strongly correlated with pulmonary involvement, but
not with gender or methotrexate usage.
Conclusion:
Pulmonary involvement in RA is frequent and significantly associated with older age and longer disease
duration, necessitating early screening and multidisciplinary management.
Keywords:
Rheumatoid arthritis, pulmonary manifestations, interstitial lung disease, methotrexate, Pakistan, tertiary
care.