Rheumatoid lung disease

Alternative Names: Lung disease - rheumatoid arthritis; Rheumatoid nodules

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)

Causes of Rheumatoid lung disease

Pulmonary abnormalities are common in rheumatoid arthritis, but 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.

Rheumatoid lung disease Symptoms

• Chest pain
• Cough
• Fever
• Shortness of breath

Other symptoms that may occur with this disease include:

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

Tests and Exams

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)

Treatment of Rheumatoid lung disease

Many people with this condition have no symptoms. Treatments are aimed at the underlying disorder and the complications caused by the disorder. Corticosteroids or other medicines that suppress the immune system are sometimes useful.

Prognosis (Outlook)

The outcome is related to the underlying disorder and the type and severity of lung disease.

Potential Complications

• Pneumothorax
• Pulmonary hypertension

When to Contact a Health Professional

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

Raghu G. Interstitial lung disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 92.

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: Saunders Elsevier; 2010:chap 58.

Bronchoscopy	Respiratory system

Review Date: 6/10/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and 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, Medical Director, A.D.A.M., Inc.

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