Despite misconceptions, rheumatoid arthritis doesn’t just affect joints. It can also damage the tissue around the joints, as well as the eyes, heart and lungs. Realistically, they should call it rheumatoid disease because it can damage the whole body. Additionally, lung complications of RA can be quite serious and contribute to about 20 percent of the deaths related to rheumatoid arthritis.
Lung related complications of RA include interstitial lung disease, pulmonary fibrosis, nodules, and pleurisy.
Interstitial Lung Disease: Also referred to as RA-ILD, it is the most serious lung complication for people with RA. It can be hard to detect but occurs when the tissues surrounding the lung became inflamed and scarred. Men are at a higher risk than women for RA-ILD. Smoking increases the risk but non-smokers with RA are also at risk. Symptoms include breathlessness and dry cough, but often times, there no symptoms at all, making early detection impossible. Unfortunately, RA-ILD is difficult to treat and aside from treating RA, few options are available. Of late, there was one clinical trial for rituximab (Rituxan) and its role in treating RA-ILD but nothing has been successful to date.
Pulmonary Fibrosis: Inflammation similar to that that leads to RA-ILD can lead to pulmonary fibrosis or permanent scaring of the respiratory tissues. This scarring causes shortness of breath, since healthy air sacs become scar tissue. Unfortunately, methotrexate has been known to cause pulmonary fibrosis and patients who take this drug should be monitored for respiratory status.
Nodules: RA can cause nodules to form in the throat and vocal chords causing hoarseness and other changes. Nodules can also develop in the lungs but often times they do not cause symptoms and patients will not notice them.
Pleurisy: Research finds that nearly 50% of RA patients have damage to the lining of the lung or pleura but only about 15 to 20 percent of those affected have symptoms. Pleurisy is defined as inflammation of the pleural issue. Symptoms include chest discomfort and difficulty breathing. Fluids called effusions build up the in the pleural space and around the lungs. This can lead to persistent cough, shortness of breath, and a collapsed lung.
What You Can Do
Having RA puts you are at higher risk for lung complications. Therefore, prevention is key to reducing your risk.
Don’t Smoke: If you do, ask your doctor how you can quit smoking. In addition to smoking being a risk factor, chemicals in cigarettes can irritate already affected lung issue and this can lead to even more serious complications.
Have regular checkups: Your doctor should listen to your lungs and monitor your breathing at each visit. If lung problems are found early, they are easier to treat. Additionally, if you have RA and suffer from shortness of breath, coughing, or other respiratory symptoms, get in contact with your doctor right away. These are pretty serious issues that need immediate attention.
Source: Brichford, Connie (Medically reviewed by Niya Jones, MD, MPH), How Rheumatoid Arthritis Affects the Lungs; http://www.everydayhealth.com/rheumatoid-arthritis/rheumatoid-arthritis-lungs.aspx
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