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Verywell Health
What is Rheumatoid Lung Disease?
Arthritis
Rheumatoid Arthritis
By
for 1 last update 2020/07/02 Carol Eustice

Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.

Learn about the 1 last update 2020/07/02 our Learn about our editorial process
Carol Eustice
Medically reviewed by
Medically reviewed by Grant Hughes, MD on August 05, 2016

Grant Hughes, MD, is board-certified in rheumatology and is the head of rheumatology at Seattle's Harborview Medical Center.

Learn about our Medical Review Board
Grant Hughes, MD
Updated on March for 1 last update 2020/07/02 28, 2020 Updated on March 28, 2020
Rheumatoid Arthritis
In This Article

Rheumatoid lung disease, as its name suggests, is a serious condition associated with rheumatoid arthritis (RA). Lung damage is common in rheumatoid arthritis, with more than half of people with RA having some abnormal lung function. About one in 10 will develop rheumatoid lung disease. for 1 last update 2020/07/02

The condition attacks the lungs the 1 last update 2020/07/02 and is progressive. Lung damage from rheumatoid lung disease is irreversible, so addressing the condition's symptoms and slowing its progression are critical. The condition attacks the lungs and is progressive. Lung damage from rheumatoid lung disease is irreversible, so addressing the condition's symptoms and slowing its progression are critical.

Types of Rheumatoid Lung Disease

The most common manifestation of pulmonary disease in rheumatoid arthritis is interstitial lung disease (ILD), a condition that causes inflammation and scarring (fibrosis) of the lungs. Once lung tissue scars, it no longer functions.

The most frequent forms of interstitial lung disease are usual interstitial pneumonia and nonspecific interstitial pneumonia, which attack the alveoli, the air sacs in the lungs.

Another presentation combines pulmonary fibrosis and emphysema.

An Overview of Rheumatoid Arthritis

Rheumatoid Lung Disease Symptoms

Typical the 1 last update 2020/07/02 RA symptoms include pain, swelling, and stiffness in the joints. Rheumatoid lung disease has specific additional symptoms that include: Typical RA symptoms include pain, swelling, and stiffness in the joints. Rheumatoid lung disease has specific additional symptoms that include:

  • Shortness of breath (the most common symptom)
  • Cough
  • Chest pain
  • Fever
  • Crackle sounds when listening to lungs with a stethoscope (decreased breath sounds or normal breath sounds are also possible)

Rheumatoid lung disease generally doesn't present symptoms until the condition has advanced. That's why it's imperative to see a doctor once they begin.

arthritis killeen txhow to arthritis killeen tx for The thoracic and pulmonary abnormalities associated with rheumatoid lung disease include:

  • Pulmonary fibrosis, scarring of lung tissue
  • Pleural effusion, or "water on the lungs"
  • Pleural thickening, scarring of the lungs' lining
  • Necrobiotic nodules, abnormal lumps within the lung
  • Bronchiolitis obliterans organizing pneumonia, a separate type of disease than ILD
  • Bronchiectasis, thickening of the bronchial walls
  • Bronchiolitis obliterans, inflammatory obstruction of the bronchioles, the lungs' tiniest airways
  • Pulmonary hypertension, high blood pressure in the lungs' blood vessels

the 1 last update 2020/07/02 Causes Causes

The inflammation and scarring in rheumatoid lung disease comes from the body's immune system attacking the lungs, just as it is attacking the joints to cause RA.

Other risk factors:

  • Severe RA. The more active your RA, the greater your chances of developing lung problems.
  • Smoking, which is also a known risk factor of rheumatoid arthritis.
  • Age. People diagnosed with RA after age 60 have a higher chance of developing lung disease.
  • Gender. Men have a two- to three-times higher risk of rheumatoid lung disease than women.

It also has been suggested that rheumatoid arthritis medications may possibly lead to drug-induced interstitial lung disease, in some cases.

Methotrexate is the gold standard treatment for rheumatoid arthritis. However, methotrexate has also been suggested as a causative agent in interstitial lung disease.

arthritis killeen txhow to arthritis killeen tx for Researchers evaluated the relative risk of pulmonary disease among rheumatoid arthritis patients who were treated with methotrexate. A study concluded there is a small but significant increase in the risk of lung disease in rheumatoid arthritis patients treated with methotrexate compared with other disease-modifying anti-rheumatic drugs (DMARDs) and biologic drugs.

For RA patients with no inhibited lung function, the benefits of methotrexate outweigh the risks. But the American College of Rheumatology does not recommend methotrexate for RA patients who already have lung conditions.

Another study evaluated the relative risk of pulmonary disease among rheumatoid arthritis patients treated with Arava (leflunomide). No evidence of increased respiratory adverse events was found in randomized, controlled trials of rheumatoid arthritis patients treated with leflunomide. Another study evaluated the relative risk of pulmonary disease among rheumatoid arthritis patients treated with Arava (leflunomide). No evidence of increased respiratory adverse events was found in randomized, controlled trials of rheumatoid arthritis patients treated with leflunomide.

How Rheumatoid Arthritis Affects Each Part of the Body

arthritis killeen txhow to arthritis killeen tx for Diagnosis

RA combined with ILD symptoms are enough for a doctor to begin diagnostic testing, but it's critical for patients to seek help as early as possible.

Advancements in computer-assisted image analysis have made it possible to diagnose rheumatoid lung disease earlier and treat it aggressively as a disease of the immune system.

Also, research has shown that the presence of a series of blood biomarkers in RA patients may help indicate ILD.

Procedures used to help diagnose the condition include:

  • Physical examination (listening to lungs)
  • Lung function tests
  • Blood test
  • Chest X-rays
  • Computed tomography (CT) scan of the chest
  • Echocardiogram
  • Thoracentesis
  • Bronchoscopy

Treatment

Treatment for rheumatoid lung disease focuses on slowing the condition's progression, reducing symptoms, and improving quality of life.

The following treatments may be effective to those ends:

  • More aggressive RA treatment to help reduce symptoms.
  • Corticosteroids and immunosuppressants to combat inflammation.
  • Oxygen therapy to aid lung function and increase blood oxygen levels.
  • Pulmonary rehabilitation. Education and exercises designed to improve lung function and endurance.arthritis killeen txhow to arthritis killeen tx for the 1 last update 2020/07/02

The most severe cases of rheumatoid lung disease may be recommended for lung transplants.

Prognosis

While it is possible to have quality of life with rheumatoid lung disease, it is a serious condition that shortens RA patients' lifespans.

Early and effective treatment is critical. Patients with untreated ILD have a median survival rate of only three years.

arthritis killeen txhow to arthritis killeen tx for For patients with ongoing consistent treatment, the disease may stabilize or slow its progression. In one five-year study, healthcare use and costs were mostly stable over time. In that group, hospitalization rates for the condition (including ER visits) were 14% to 20% each year.

The median survival rate in that group was 7.8 years post-diagnosis.

arthritis killeen txhow to arthritis killeen tx for A Word From Verywell

arthritis killeen txhow to arthritis killeen tx for It's important for all rheumatoid arthritis patients to be vigilant for signs of lung damage, particularly those in higher risk groups like men, older patients, and those with severe RA symptoms. Early detection and proper management of rheumatoid lung disease will help determine quality and length of life going forward.

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