A scan of lungs.
Rheumatoid lung disease is what happens when lungs become scarred and inflamed.

What to Know About Rheumatoid Lung Disease

Rheumatoid arthritis is a major global health issue that most of us are familiar with. Affecting 350 million people worldwide, rheumatoid arthritis influences the personal and professional lives of an astonishing number of people, and rheumatoid lung disease can occur.

Most people are familiar with the basic symptoms of rheumatoid arthritis, which include pain and swelling of the joints, particularly of the hands, wrists, knees, and shoulders. However, rheumatoid arthritis is a complex autoimmune disorder that can have symptoms outside the joints. One area that rheumatoid arthritis can affect is the lungs.

What Exactly is It?

It is a generic term that refers to several different lung conditions that often occur at the same time as rheumatoid arthritis. All the forms of rheumatoid lung disease are the result of inflammation and scarring in the lungs. The forms include:

  • Interstitial lung disease: This is when the tissue of the lung becomes scarred and inflamed, which makes it stiff. This stiffness can make it difficult or painful to breathe and may contribute to high blood pressure.
  • Pleural effusions: This is when fluid builds up between the lungs and the wall of the chest. While some mild cases may clear up on their own, pleural effusions can quickly become serious and cause life-threatening complications.
  • Rheumatoid nodules: Nodules, or hard lumps of tissue, can form in many areas for people with rheumatoid arthritis, including the lungs. Rheumatoid lung nodules are often harmless and may go unnoticed if they are the only symptom of rheumatoid lung disease, but a ruptured nodule may pose a risk of a collapsed lung.

More generally, it may cause the following symptoms:

  • Shortness of breath or difficulty breathing
  • Weakness or fatigue
  • Dry cough
  • Decreased appetite or unintended weight loss

What Causes Rheumatoid Lung Disease?

RA is not an injury. It is an autoimmune disorder that occurs when the body’s immune system attacks the joints. The inflammation caused by rheumatoid arthritis can then spread to other areas of the body.

It’s difficult to predict when and if a person with rheumatoid arthritis will be affected by this lung condition. While the two have been observed to be connected—about 10% of people with rheumatoid arthritis will develop rheumatoid lung disease—the precise nature of this link is not known.

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However, there are certain risk factors to watch for. It is more likely to develop in men over 60, those who have more active arthritis, and those who are being treated for their arthritis with methotrexate and other DMARD medications.

Lung damage induced by arthritis medications is rare and is usually reversible when it occurs by switching treatments.

Treatment Options

Like rheumatoid arthritis, there is no single one-size-fits-all treatment for rheumatoid lung disease. The treatment may vary between people and depends on the progression of the disease. In all cases, the goal is to reduce inflammation throughout the body.

Some of the treatments include:

  • Changing rheumatoid arthritis treatment: Rheumatoid lung disease may be a sign that rheumatoid arthritis is getting worse, so doctors may recommend a more aggressive course of treatment or switching medication (especially if you take methotrexate or another DMARD medication).
  • Corticosteroids or immunosuppressants: These can help reduce inflammation to relieve symptoms. They may already be a part of a patient’s rheumatoid arthritis treatment.
  • Oxygen therapy: Patients who have more severe cases of rheumatoid lung disease where breathing is very strained may benefit from oxygen treatment to aid lung function and increase the flow of oxygen.
  • Pulmonary rehabilitation: Much like physical therapy may help with the joint issues of rheumatoid arthritis, so too can pulmonary rehabilitation help with rheumatoid lung disease. Pulmonary therapy consists of a series of exercises designed to improve lung function and general fitness.
  • Surgery: Surgery is reserved for more severe cases of rheumatoid lung disease, but there are a few instances in which surgery may be necessary. In cases of interstitial lung disease fluid may need to be drained from the lungs. And some cases of rheumatoid lung disease can cause a collapsed or damaged lung that may require removal or transplantation. However, these are the extreme cases.

Can It Be Prevented?

Unfortunately, this condition is difficult to predict and therefore difficult to prevent. The best strategy for reducing your risk is to continue to treat your arthritis as usual. The more arthritis inflammation you have, the greater risk you have of developing rheumatoid lung disease.

You can also minimize your risk by not smoking, monitoring yourself for respiratory symptoms, and by having regular checkups for any lung issues. If rheumatoid lung disease is caught early it may be easier to treat, so any patient with rheumatoid arthritis should be aware of this secondary condition.