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Importance of Smoking in Pulmonary Involvement of Rheumatoid Arthritis



Objectives:  The aim of this study was to evaluate the effect of smoking on disease activity and pulmonary involvement in patients with rheumatoid arthritis (RA).  

Methods: Bronchoscopy with bronchoalveolar lavage (BAL) was performed in patients who were diagnosed as rheumatoid arthritis with pulmonary involvement. Rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), C-reactive protein (CRP), and erythrocyte sedimentation rates were recorded to evaluate disease activity. BAL findings were compared between smoker and non-smoker patients with RA and age-matched healthy controls.

Results: A total of 34 patients were included in the study. The age of onset for RA found to be lower (45.35±8.44 vs 50.82±13.02, p=0.005) and duration of disease found to be shorter (6.67±5.67 vs 11.26±9.09, p=0.005) in the smoker group. There was a significant correlation between smoking history and positivity of RF and anti-CCP. Alveolar macrophages in the BAL fluid was higher in patients with RA, whereas neutrophil count was higher in healthy controls. No significant difference was found between smoker and non-smoker patients in terms of BAL fluid findings.

Conclusion: Smoking might be associated with markers of disease activity, younger age of onset and pulmonary involvement within shorter disease duration in rheumatoid arthritis.

08 Feb, 2016
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e-Published: 31 Mar, 2016


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