Assessment Of Bronchoalveolar Lavage Cytology in Rheumatoid Arthritis Patients: analytical cross-sectional study.

Abstract: Background Rheumatoid arthritis (RA) is a chronic inflammatory disease where lung involvement, like interstitial lung disease (ILD), increases morbidity. Bronchoalveolar lavage (BAL) cytology helps analyze lung inflammation. This study assessed BAL cytology in RA patients to estimate pulmonary affection prevalence. Methods This analytical cross-sectional study (February–October 2024) at Kobry El-Kobba and El-Maadi Military Hospital Complex, Egypt, included 62 RA patients. Assessments included clinical exam, lab tests (RF, anti-CCP), pulmonary function tests (PFTs), high-resolution CT (HRCT), and bronchoscopy with BAL. Patients were grouped: Group I (with lung involvement, n=20) and Group II (without, n=42). Data were analyzed using SPSS v21 (p≤0.05 significant). Results Mean age was 53.52±8.46 years, with equal gender distribution. HRCT detected lung involvement in 32.3% of patients; common patterns were traction bronchiectasis (21%) and usual interstitial pneumonia (16.1%). PFTs showed reduced forced vital capacity (FVC; 68.03%±10.03%). BAL cytology predominance was alveolar macrophages (43.5%), lymphocytes (33.9%), and neutrophils (16.1%). Group I had significantly lower FVC, higher dyspnea (70% vs. 38.1%), and more BAL inflammatory cells than Group II. Conclusion Pulmonary involvement affects about one-third of RA patients. BAL cytology reveals distinct inflammatory profiles correlating with clinical and radiological findings. Routine HRCT, PFTs, and BAL are recommended for early detection and management.