Rheumatoid lung disease: Symptoms, diagnosis, and treatment Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What to know about rheumatoid lung diseaseMedically reviewed by Adithya Cattamanchi, M.D., Pulmonology — By MaryAnn De Pietro, CRT — Updated on July 3, 2022Rheumatoid lung disease involves a group of lung conditions associated with rheumatoid arthritis. Rheumatoid arthritis (RA) usually affects the joints, but it can also lead to scarring, inflammation, and nodules in the lungs. This can affect a person’s breathing. This article looks at rheumatoid lung disease, why it happens, the types, symptoms, diagnosis, treatments, and outlook. What causes rheumatoid lung disease Share on PinterestMaskot/Getty ImagesRheumatoid lung disease can develop as a complication of RA and a 2015 research article notes that lung problems are a major cause of illness and fatality in people with this disease. The authors say this can happen because of:persistent activation of the immune systemincreased susceptibility to infections, which can stem from the use of medications that regulate the immune systemtoxicity resulting directly from drugs that treat RA RA is an autoimmune disease that affects the joints, but some people also develop inflammation and scarring in the lungs and other parts of the body. Beyond the joints, the lungs are the most common site where people with RA develop inflammation. According to the Arthritis Foundation, about 10% of people with RA develop interstitial lung disease (ILD). ILDs are a group of diseases and the most common type of lung disease to occur with RA. Types of rheumatoid lung disease Rheumatoid lung disease can take various forms. Types of rheumatic lung disease include:ILDs, which cause scarring in the lungsinflammation and thickening of the pleura, with effusionsvasculitispulmonary hypertension ILDs are types of pulmonary parenchymal disease. This means they affect the area around the lungs’ air sacs. Vasculitis and pulmonary hypertension are vascular diseases. They involve the lungs’ blood vessels. There may also be a higher risk of infection, which can increase the risk of lung damage. Risk factors People with RA have an eight times higher risk of developing lung disease than those without RA. Some people with RA may have specific factors that increase the risk of lung involvement. A 2014 study looked at data for 230 people with a history of RA. Results showed that the most significant risk factor for developing rheumatoid lung disease was high levels of anti-CCP antibodies. Anti-CCP antibodies are a type of protein that the immune system produces. Testing positive for anti-CCP antibodies is one indicator of RA. High levels may indicate the severity of the disease. Other factors that may increase the risk are:having active disease in the jointsbeing malesmoking, specifically in malesbeing older, as the average age at diagnosis is 64 years People with RA may also have a higher risk of:Sjogren’s syndromelymphomadepressioncardiovascular complications, including coronary artery disease and blood clotsosteoporosis Symptoms The symptoms of rheumatoid lung disease may vary, depending on the condition. Sometimes, respiratory symptoms appear before symptoms of RA affect the joints. Rheumatoid lung diseases can involve:inflammation of the pleurascarring of the lungspleural effusion, a buildup of fluid between the chest wall and the lungsnodules or small growthsairway damage, known as bronchiectasis, which can occur with RA-related lung diseasevasculitispulmonary hypertension, high blood pressure that affects the lungs Lung nodules may not cause any symptoms, but scarring due to ILD can lead to shortness of breath and a dry cough. Many of the symptoms of rheumatoid lung disease also occur with other respiratory conditions. Diagnosis If a doctor suspects a person may have rheumatoid lung disease, they will: take a medical history do a physical examrecommend some tests Tests that can help diagnose rheumatoid lung disease include:blood tests to measure markers of inflammation, such as sedimentation rate and C-reactive proteinsa high-resolution CT scan, which can reveal any scarring in the lungsa lung function test, which measures how much air a person can blow out of their lungs, the volume of air in the lungs, and how much oxygen passes into the bloodstreama lung biopsy, in some cases, to rule out cancerbronchoscopy, to sample lung fluid for testing in a laboratory if a doctor suspects infectionthoracentesis, where a doctor takes a sample of pleural fluid for testing Treatment Treatment for rheumatoid lung disease will depend on the person’s symptoms, the type of lung disease, and how the disease affects the body. A person with small lung nodules and no symptoms may not need treatment. Treatment cannot reverse any existing damage, but it can help slow the progression of RA-related lung disease and help manage symptoms. Medication In 2019, the Food and Drug Administration (FDA) approved nintedanib (Oftev) oral capsules to treat chronic, progressive ILDs that involve scarring. This means it is suitable for many people with rheumatoid lung diseases. Clinical trials had shown that, in people with fibrosing (scarring) ILD who used nintedanib, the disease progressed more slowly than in those who took a placebo. However, participants did not see any improvement in their quality of life. Adverse effects of the drug included:nauseavomitingdiarrhea Doctors sometimes prescribe corticosteroids to reduce inflammation. In 2015, however, researchers noted that it was unclear whether these medications were beneficial. They can also have adverse effects. Other options Other treatment options include:oxygen therapy to improve a person’s quality of lifea lung transplant, in some casespulmonary rehabilitation, which teaches people about lung disease and tips for managing symptomsaerobic exercise Does medicare cover pulmonary rehab? Outlook The outlook will depend on factors such as the severity and the type of disease a person has. Scarring and ILD can significantly impact a person’s life expectancy, according to research from 2013. Data from 10 studies suggested that the median survival rate for people with ILD due to RA was 3.2–8.1 years after their diagnosis. It is not possible to know exactly how RA-related lung disease will affect an individual. Lung problems can change over time, with symptoms becoming more severe and new complications developing. Seeking help early may improve the prognosis. The outlook for a person with ILD is linked to how widespread the scarring is at the time of diagnosis. Prevention It is not always possible to prevent rheumatoid lung disease, but the following approaches can help reduce the risk:avoiding smoking following a treatment plan for RAattending regular checkups to monitor breathing and check for lung problemsfollowing a doctor’s recommendations about the flu, COVID-19, and other vaccinesseeking medical advice at once if a cough or shortness of breath occur Treatment might be more effective if a person has an early diagnosis. Frequently asked questions People often ask the following questions about rheumatoid lung disease. How long can you live with rheumatoid lung disease Factors affecting the outlook include the person’s age, the type of lung disease, and other factors. In 2013, one study concluded that the median survival rate for a person with ILD was 3.2–8.1 years, but it can vary. What happens when RA attacks the lungs RA involves inflammation, and this can lead to scarring in the lungs, known as interstitial lung disease. Problems can also arise with the blood vessels, and a person may be more prone to infections. Summary RA usually affects the joints, but it can impact other body systems. A person with RA will have a higher risk of ILD and other lung diseases. These diseases can lead to inflammation, nodules, scarring in the lungs, pleural effusion, and other airway issues. Anyone with a diagnosis of RA should follow a doctor’s instructions regarding treatment and monitoring and seek medical advice if they develop a cough or breathing problems. Avoiding smoking may also help reduce the risk. Treatment cannot reverse lung damage, but it may help slow the progression of lung disease. Last medically reviewed on July 3, 2022Rheumatoid ArthritisMedically reviewed by Adithya Cattamanchi, M.D., Pulmonology — By MaryAnn De Pietro, CRT — Updated on July 3, 2022 Latest newsWhat sets 'SuperAgers' apart? 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