Rheumatoid lung disease

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Alternative names
Lung disease - rheumatoid arthritis

Definition
Rheumatoid lung disease is associated with rheumatoid arthritis and includes pleural effusions, pulmonary fibrosis, lung nodules, and pulmonary hypertension.

Causes, incidence, and risk factors
Pulmonary abnormalities are common in rheumatoid arthritis, but they often have no symptoms. The causes of lung disease associated with rheumatoid arthritis are unknown. Sometimes the medicines used to treat rheumatoid arthritis may result in lung disease.

Symptoms

• Shortness of breath
  
• Cough
  
• Chest pain
  
• Fever

Additional symptoms that may be associated with this disease include the following:

• Joint swelling
  
• Joint stiffness
  
• Joint pain
  
• Skin nodules

Signs and tests
Crackles may be heard when listening to the lungs with a stethoscope (auscultation). Alternatively, there may be decreased breath sounds, a “rub,” or normal breath sounds.

• A chest X-ray may show abnormalities consistent with rheumatoid lung disease.
  
• A CT scan of the chest may show abnormalities consistent with rheumatoid lung disease.
  
• An Echocardiogram may show pulmonary hypertension.
  
• A thoracentesis (putting a needle into fluid around the lung) may show characteristics of rheumatoid lung disease.
  
• A bronchoscopic, video-assisted, or open lung biopsy may show findings consistent with rheumatoid lung disease.

Treatment
Many people have no symptoms. Therefore, treatment is aimed at the underlying disorder and for specific complications resulting from this disorder. Corticosteroids or other immunosuppressive therapy are sometimes useful.

Expectations (prognosis)
The outcome is related to the underlying disorder and the type and severity of lung disease.

Complications

• Pneumothorax
  
• Pulmonary hypertension

Calling your health care provider
Call your health care provider PROMPTLY if you have rheumatoid arthritis and unexplained breathing difficulties occur.

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