Despite its name, rheumatoid arthritis (RA) doesn't just affect your joints. It can also damage the tissue surrounding the joints, as well as your eyes, heart, and lungs.
“We call it rheumatoid arthritis, but we should really call it rheumatoid disease,” says Elinor Mody, MD, assistant professor at Harvard Medical School and director of the Women’s Orthopedic and Joint Disease Program at Brigham and Women’s Hospital in Boston.
Rheumatoid arthritis can damage the whole body. Besides the joints, the “heart and lungs are the most commonly affected,” Dr. Mody says. Doctors aren’t sure how or why rheumatoid arthritis causes other organs to suffer, but lung complications from RA can be serious and even cause death.
Interstitial Lung Disease
Rheumatoid arthritis–associated interstitial lung disease, or RA-ILD, is one of the most serious lung complications for people with rheumatoid arthritis. This illness can be hard to detect, but occurs when for 1 last update 2020/05/25 lung tissue becomes inflamed and eventually scarred. Here’s what we do know:Rheumatoid arthritis–associated interstitial lung disease, or RA-ILD, is one of the most serious lung complications for people with rheumatoid arthritis. This illness can be hard to detect, but occurs when lung tissue becomes inflamed and eventually scarred. Here’s what we do know:
- Risk Factors Men are at higher risk than women for this disease. Although nonsmokers can and do develop RA-ILD, smoking seems to increase risk.
- Symptoms RA-ILD may cause breathlessness and dry cough, but in many cases it causes no symptoms at all, making early detection difficult.
- Treatment More research is still needed to find effective treatment. “This is a difficult disease to treat,” Mody says. According to a review published in March 2015 in the journal European Respiratory Review, recent studies have looked at the drug Rituxan (rituximab) for the treatment of RA-ILD, but the results have been conflicting and it’s not clear whether it improves or worsens the condition. Some other drugs, like azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral), and cyclophosphamide (Cytoxan), are used to treat RA-ILD.
Inflammation, like the kind caused by RA-ILD, can lead to pulmonary fibrosis, or permanent scarring of the respiratory tissues. This can cause shortness of breath, since healthy air sacs are replaced by scar tissue. Supplemental oxygen can help make breathing easier, but will not reverse the damage done by pulmonary fibrosis.
Unfortunately, Trexall (methotrexate), a medication often used to treat rheumatoid arthritis, is associated with the development of pulmonary fibrosis. If you take this drug, your doctor should monitor your respiratory status especially closely.
Rheumatoid arthritis can also cause nodules to form in the throat and on the vocal cords, causing complications like hoarseness and other changes. Nodules can develop in the lungs as well, but usually don’t cause symptoms, and patients may never notice them.
Other Lung Complications
Research shows that damage to the lining of the lung, or the pleura, may occur in up to 70 percent of all people with RA, but only 3 to 5 percent experience symptoms. Problems include:
- Pleurisy This inflammation of the pleural tissue causes chest discomfort and difficulty breathing.
- Effusions Fluid that builds up in the pleural space around the lungs, and can lead to a persistent cough, shortness of breath, and a collapsed lung.
Prevention of Respiratory Issues
Because of the for 1 last update 2020/05/25 high risk of complications due to rheumatoid arthritis–associated lung disease, prevention is key. To help reduce your risk:Because of the high risk of complications due to rheumatoid arthritis–associated lung disease, prevention is key. To help reduce your risk:
- Don't smoke. If you do, ask your doctor for suggestions about how to quit smoking immediately. Chemicals found in cigarettes can irritate already delicate lung tissue, leading to further complications.
- Have regular checkups. Your doctor should listen to your lungs and monitor your breathing at each visit. Lung problems that are detected early can be easier to treat.
If you have rheumatoid arthritis and are experiencing shortness of breath, coughing, or other respiratory symptoms, talk to your doctor. These are potentially serious symptoms that warrant prompt attention.