Summary
Pericardial and lung involvement in rheumatoid arthritis (RA), suspected to be less severe in a developing nation (Turkey), have been evaluated. We have studied clinical, echocardiographic and pulmonary findings (radiological and functional) in 93 consecutive Turkish patients with definite/classical RA. Findings were compared with those of a group of patients with osteoarthritis or local rheumatological conditions (n=60) in a blind protocol. Fifty patients with systemic lupus (SLE) were studied as a high risk control group for pericardial involvement. While pericardial disease was detected in 5.5% (5/90) of RA patients, it was detected in 6.6% (4/60) of the control patients. SLE patients had a 26% (13/50) prevalence. Interstitial lung disease was found in 27.7% of RA patients but it was present in 6.6% (4/60) of the control patients. We observed that a group of patients with RA in Turkey had a low prevalence of pericardial disease. This is further evidence that RA has a mild course in developing countries.
Similar content being viewed by others
References
Perry, J.D., Wheatcroft, J., Sakarcan, A., Yurdakul, S., Ozdogan, H., Yazici, H. A comparative study of rheumatoid disease in Istanbul and London: clinical, serological and genetic features. (Abstract) XI th European Rheumatology Congress 1987, 62.
Greenwood, B.M. Polyarthritis in Western Nigeria I: rheumatoid arthritis. Ann Rheum Dis 1969, 28, 488–496.
Kanyerezi, B.R., Baddeley, H., Kuumbo, D. Rheumatoid arthritis in Ugandan Africans. Ann Rheum Dis 1970, 29, 617–621.
Chopra, A., Raghunath, D., Singh, A., Subramanian, A.R. The pattern of rheumatoid arthritis in the Indian population: a prospective study. Br J Rheum 1988, 27, 454–456.
Beasley, R.P., Bennett, P.H., Lin, C.C. Low prevalence of rheumatoid arthritis in Chinese: prevalence survey in a rural community. J Rheumatol 1983, 10 (suppl. 10), 11–15.
Brighton, S.W., de la Harpe, A.L., van Staden, D.S., Badenhorst, J.H., Myers, O.L. The prevalence of rheumatoid arthritis in a rural African population. J Rheumatol 1988, 15, 405–408.
Wood, P.H.N., Penn, T. Statistical appendix: digestion data on rheumatoid arthritis 3. Handicap and disability on international comparison of morbidity and morality. Ann Rheum Dis 1972, 31, 72–77.
Ropes, M.W., Benneth, G.A., Cobb, S., Jacox, S., Sessar, R.A. 1958 revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis 1958, 9, 175–176.
Tan, E.M., Cohen, A.S., Fries, J.G., Masi, A.T., McShane, D.J., Rothfield, N.F., Schaller, J.G., Tallal, N., Winchester, R.J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982, 25, 1271–1277.
Steinbrocker, O., Traeger, Ch., Baetterman, R.O. Therapeutic criteria for rheumatoid arthritis. JAMA 1949, 140, 659–662.
Ozkan, M., Koçak, H., Emel, O., Basaran, Y., Ozdemir, M., Ozdogan, H., Yazici, H. Two DE and doppler echocardiography results in fifty patients with systemic lupus erythematosus. (Abstract) 7 th International Congress on Echocardiography 1990, 276.
Horowitz, M.S., Schultz, C.S., Stinson, E.B., Harrison, D.C., Popp, R.L. Sensitivity and specificity of echocardiographic diagnosis of pericardial effusion. Circulation 1974, 50, 239–247.
American Thoracic Society (ATS) Statement. Snowbird workshop on standardization of spirometry. Am Rev Respir Dis 1979, 199, 831–838.
Bates, D.V., McLem, P.T., Christie, R.V. The normal physiology and methods of study. In: Respiratory Function in Disease. Philadelphia. Ed.: WB Saunders, 1971, 11–95.
Hakala, M. Poor prognosis in patients with rheumatoid arthritis hospitalized for interstitial lung fibrosis. Chest 1988, 93, 114–118.
Wise, R.A., Wigley, F.M., Scott, T.E., Hochberg, M.C. HLA-DQw alloantigens and pulmonary dysfunction in rheumatoid arthritis. Chest 1988, 94, 609–614.
Mountz, J.D., Turner, R.A., Collins, R.L., Gallup, K.R., Semble, E.L. Rheumatoid arthritis and small airways function: effects of disease activity, smoking and alpha-1 antitrypsin deficiency. Arthritis Rheum 1984, 27, 728–736.
Davidson, C., Brooks, A.G.F., Bacon, P.A. Lung function in rheumatoid arthritis: a clinical survey. Ann Rheum Dis 1974, 33, 293–297.
Collins, R.L., Turner, R.A., Johnson, A.M., Whitley, N.O., McLean, R.L. Obstructive pulmonary disease in rheumatoid arthritis. Arthritis Rheum 1976, 19, 623–628.
Hunninghake, G.W., Fauci, A.S. Pulmonary involvement in the collagen vascular diseases. Am Rev Respir Dis 1979, 119, 471–503.
Shiel, W.C., Prete, P.E. Pleuropulmonary manifestations of rheumatoid arthritis. Seminars in Arthritis Rheum 1984, 13, 235–243.
Begin, R., Masse, S., Cantin, A., Menard, H.A., Bureau, A.M. Airway disease in a subset of nonsmoking rheumatoid patients: characterization of the disease and evidence for an autoimmune pathogenesis. Am J Med 1982, 72, 743–780.
McGill, P. Rheumatoid arthritis in sub-Saharan Africa. Ann Rheum Dis 1991, 50, 965–966.
Adebajo, A.O. Rheumatology in the Third World. Ann Rheum Dis 1990, 49, 813–816.
Mody, G.M., Meyers, O.L. Rheumatoid arthritis in blacks in South Africa. Ann Rheum Dis 1989, 48, 69–72.
Stein, M., Davis, P. Rheumatoid disorders in Zimbabwe: a prospective analysis of patients attending a rheumatic disease clinic. Ann Rheum Dis 1990, 49, 400–402.
Wicks, I.P., Moore, J., Fleming, A. Australian mortality statistics for rheumatoid arthritis 1950–81: analysis of death certificate data. Ann Rheum Dis 1988, 47, 563–569.
Drossos, A.A., Lanchbury, J.S., Panayi, G.S., Moutsopoulos, H.M. Rheumatoid arthritis in Greek and British patients: a comparative clinical, radiologic and serologic study. Arthritis Rheum 1992, 35, 745–748.
Mody, G.M., Stevens, J.E., Meyers, O.L. The heart in rheumatoid arthritis: a clinical and echocardiographic study. Quarterly J Med 1987, 247, 921–928.
Nomier, A.M., Turner, R.A., Watts, L.E., Smith, D., West, G., Edmonds, J. Cardiac involvement in rheumatoid arthritis. Ann Int Med 1973, 79, 800–806.
Prakash, R., Attasi, A., Paske, R., Rosen, K.M. Prevalence of pericardial effusion and mitral valve involvement in patients with rheumatoid arthritis without cardiac symptoms. N Eng J Med 1973, 289, 597–600.
Bacon, P.A., Gibson, D.G. Cardiac involvement in rheumatoid arthritis: an echocardiographic study. Ann Rheum Dis 1973, 33, 20–24.
Hernandez-Lopez, E., Chahine, R.A., Anastassiades, P., Raizner, A.E., Lidsky, M.D. Echocardiographic study of the cardiac involvement in rheumatoid arthritis. Chest 1977, 72, 52–55.
Mac Donald, W.S., Crawford, M.H., Klippel, J.H., Zvaifler, N.J., O'Rourke, R.A. Echocardiographic assessment of cardiac structure and function in patients with rheumatoid arthritis. Am J Med 1977, 63, 890–896.
Nomier, A.M., Turner, R.A., Watts, L.E. Cardiac involvement in rheumatoid arthritis: follow-up study. Arthritis Rheum 1979, 22, 561–564.
Rantapaa-Dahlqvist, S., Backman, C., Bjerle, P., Johnson, O. Is HLA-B27 antigen a predictor of cardiac or pulmonary disease in patients with rheumatoid arthritis? Scand J Rheumatol 1991, 20, 165–171.
Aranoff, A., Bywaters, E.G.L., Fearnly, G.R. Lung lesions in rheumatoid arthritis. British Med J 1955, 2, 228–232.
Walker, W.C., Wright, V. Rheumatoid pleuritis. Ann Rheum Dis 1967, 26, 467–474.
Kirk, J., Cash, J. The pericarditis of rheumatoid arthritis. Quarterly J Med 1969, 152, 397–423.
Mac Farlene, J.D., Dieppe, P.A., Ridgon, B.C., Clarck, T.J.H. Pulmonary and pleural lesions in rheumatoid disease. Br J Dis Chest 1978, 72, 288–300.
Hyland, R.H., Gordon, D.A., Brader, I., Davies, G.M., Russel, M.L., Hutcheon, M.A., Reid, G.D., Cox, D.V., Corey, P.N., Mintz, S. A systematic controlled study of pulmonary abnormalities in rheumatoid arthritis. J Rheumatol 1983, 10, 395–405.
Max, N.I.J., Ogeda, W., Ogeda, V. Pleuropulmonary necrobiotic lung nodules: a review and clinicopathological study of six patients. The Med Journal of Australia 1986, 144, 648–651.
Popper, M.S., Bogdonof, M.L., Hughes, R.L. Interstitial rheumatoid lung disease: a reassessment and review of the literature. Chest 1972, 62, 243–250.
Gordon, D.A., Stein, J.L., Broder, I. The extraarticular features of rheumatoid arthritis: a systematic analysis of 127 cases. Am J Med 1973, 54, 445–452.
Frank, S.T., Weg, J.G., Harkleroad, L.E., Fitch, R.F. Pulmonary dysfunction in rheumatoid disease. Chest 1973, 63, 27–34.
Whorwell, P.S., Wojtulevski, A., Lorey, B.W. Respiratory function in rheumatoid arthritis. Br Med J 1975, 2, 175.
Laitenen, O., Nissila, M., Salorinne, Y., Aalto, P. Pulmonary involvement in patients with rheumatoid arthritis. Scand J Respir Dis 1975, 56, 297–304.
Scherthaner, G., Scherak, O., Kolarz, G., Kummer, F. Seropositive rheumatoid arthritis associated with decreased diffusion capacity of the lung. Ann Rheum Dis 1976, 35, 258–262.
Hills, E.E.A., Davies, S., Geary, M. Frequency dependence of dynamic compliance in patients with rheumatoid arthritis. Thorax 1976, 34, 755–761.
Cervantez-Perez, P., Toro-Perez, A.H., Rodriguez-Jurado, P. Pulmonary involvement in rheumatoid arthritis. JAMA 1980, 243, 1715–1719.
Garcia, J.G.N., Parhami, N., Killam, J., Garcia, P.L., Keogh, P.A. Bronchoalveolar lavage fluid evaluation in rheumatoid arthritis. Am Rev Resp Dis 1986, 133, 450–454.
Geddes, D.M., Webley, W., Emerson, P.A. Airways obstruction in rheumatoid arthritis. Ann Rheum Dis 1979, 38, 222–225.
Herzog, C.A., Miller, R.R., Hoidol, J.R. Bronchiolitis and rheumatoid arthritis. Am Rev Respir Dis 1981, 124, 636–639.
Sassoon, C.S.H., McAlpine, S.W., Taskhin, D.P., Baydur, A., Qismonia, F.P., Mongan, E.S. Small airways function in nonsmokers with rheumatoid arthritis. Arthritis Rheum 1984, 27, 1218–1226.
Hakala, M., Ruuska, P., Heimeenkeorpi, R., Tiilikainen, A., Ilonen, J., Makitalo, R. Diffuse interstitial lung disease in rheumatoid arthritis: views on immunological and HLA findings. Scand J Rheumatol 1986, 15, 368–376.
Walker, W.C., Wright, V. Diffuse interstitial pulmonary fibrosis and rheumatoid arthritis. Ann Rheum Dis 1969, 28, 252–259.
Bonfiglio, T., Atwater, E.C. Heart disease in patients with seropositive rheumatoid arthritis: a controlled autopsy study and review. Arch Intern Med 1969, 124, 714–719.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Imeryüz, N., Yazici, H., Koçak, H. et al. Pericardial and pulmonary involvement in rheumatoid arthritis in Turkey. Clin Rheumatol 13, 239–243 (1994). https://doi.org/10.1007/BF02249019
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02249019