Rheumatoid lung disease
Rheumatoid lung disease is a group of lung problems related to rheumatoid arthritis. The condition can include:
- Blockage of the small airways (bronchiolitis obliterans)
- Fluid in the chest (pleural effusions)
- High blood pressure in the lungs (pulmonary hypertension)
- Lumps in the lungs (nodules)
- Scarring (pulmonary fibrosis)
Lung disease - rheumatoid arthritis; Rheumatoid nodules
Lung problems are common in rheumatoid arthritis. They often cause no symptoms.
The causes of lung disease associated with rheumatoid arthritis are unknown. Sometimes the medicines used to treat rheumatoid arthritis, especially methotrexate, may result in lung disease.
Other symptoms that may occur with this disease include:
Exams and Tests
The doctor may hear crackles (rales) when listening to the lungs with a stethoscope. Or, the patient may have decreased breath sounds, wheezing, a rubbing sound, or normal breath sounds.
The following tests may show signs of rheumatoid lung disease:
- Chest x-ray
- CT scan of the chest
- Echocardiogram (may show pulmonary hypertension)
- Lung biopsy (bronchoscopic, video-assisted, or open)
- Lung function tests
- Needle inserted into the fluid around the lung (thoracentesis)
Many people with this condition have no symptoms. Treatment is aimed at the health problems causing the lung problem and the complications caused by the disorder. Corticosteroids or other medicines that suppress the immune system are sometimes useful.
The outcome is related to the underlying disorder and the type and severity of lung disease. In severe cases, lung transplantation can be considered.
When to Contact a Medical Professional
Call your health care provider right away if you have rheumatoid arthritis and you develop unexplained breathing difficulties.
Corte TJ, duBois RM. The lungs and connective tissue diseases. In: Mason RJ, Broaddus VC, Martin TR, et al., eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Elsevier Saunders; 2010:chap 58.
Reviewed By: Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.