Other than the joints and heart, the lungs are the part of the body most commonly affected by rheumatoid arthritis (RA). The lung complications associated with RA can be serious and even fatal, yet often cause no symptoms. The diagnosis of lung disease in RA patients can be challenging because the symptoms of lung problems overlap with the symptoms of heart disease.
How RA may impact your respiratory system:
Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is the most serious and most common lung complication in people with RA. An estimated one in 10 people with RA will develop RA-ILD. It refers to a group of lung disorders marked by inflammation and scarring of the lung tissue, which is caused by the immune system attacking the lungs. As scarring becomes more severe it can affect breathing and lead to breathlessness and dry cough. Unfortunately RA-ILD has a high mortality rate – it is as deadly among people with RA as congestive heart failure – as there is currently no effective treatment.
Rheumatoid nodules can occur in the lungs of patients with RA
Pulmonary fibrosis, permanent scarring of the lungs, is another lung condition caused by inflammation and is often linked with RA-ILD. As the healthy air sacs are replaced by scar tissue, breathing becomes difficult. Oxygen therapy may make breathing easier, but it cannot undo the damage caused by the scarring. Methotrexate can cause pulmonary fibrosis, so people who take this drug should be monitored closely for lung disease.
Pleurisy is an inflammation of the lining of the lungs, called the pleura. It occurs in more than half of all people with RA and can make breathing painful.
It’s important to try to prevent RA-associated lung disease because of its high risk of complications.
The most important things you can do are to avoid smoking, or if you do smoke, ask your doctor for help quitting, and make sure you get regular checkups so that your doctor can listen to your lungs and monitor your breathing. If you have RA and are experiencing shortness of breath, coughing, or other respiratory symptoms, seek medical attention quickly.