Thanks much for the useful information about pulmonary function testing and a clinical perspective on a possible relationship between pulmonary fibrosis and spondyloarthropathies. All I could find on the later were research papers without adequate controls, such as
Casserly, I. P. et al. 1997. Brit. J. Rheum. 36: 677-682.
Fenlon, H.M. et al. 1997. Am. J. Roentgen. 168: 1067-1072.
Sampaio-Barros, P.D. et al. 2007. Clin. Rheum. 26: 225-230.
I did a careful literature search and could find no evidence of a relationship between spondylarthropathy and pulmonary disease, specifically no relationship to pulmonary fibrosis. There appears to be a relationship between this condition and kidney disease and inflammatory bowel disease and uveitis.
As for treatment, Phase III trials have confirmed that tumor necrosis factor antagonists are effective and safe for the treatment of ankylosing spondylitis and psoriatic arthritis. For patients who do not respond to tumor necrosis factor blockade, several treatment options are under study. Information from these trials will more clearly define the role of disease-modifying anti-rheumatic medicines, novel therapeutic agents, and antibiotics in the treatment of spondylarthropathy.
The FEV1 and FVC at 80% are borderline within normal limits. The FEV1/FVC ratio is high, a finding ordinarily associated with restrictive disease, of which pulmonary fibrosis is one. These most recent PFTs should be interpreted only in comparison to previous PFTs and PFTs to be repeated a year from now. If there is a question of restrictive disease, a chest x-ray should be done and if questionable, a CT scan of the chest.