Pulmonary fibrosis and rheumatoid arthritis What is the link

Pulmonary fibrosis and rheumatoid arthritis What is the link

Pulmonary fibrosis and rheumatoid arthritis: What is the link? 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With this condition, lung tissue becomes thick and scarred, making it harder to absorb oxygen into the bloodstream. Share on PinterestChinnapong/Getty ImagesRA is an autoimmune inflammatory condition that causes chronic pain in the joints. It can also affect other organs, such as the lungs, causing severe breathing problems that health experts call pulmonary fibrosis. What is RA-linked pulmonary fibrosis Pulmonary fibrosis is a type of interstitial lung disease. It is part of many different lung conditions that can cause inflammation in the air sacs of the lungs, as well as in lung tissue and the air space between the sacs. When such a condition also causes scarring, health experts refer to it as pulmonary fibrosis. Scarring can block oxygen from moving from the lungs to the blood. This in turn can lead to shortness of breath, especially when a person is experiencing exertion. Doctors still do not fully understand the link between RA and pulmonary fibrosis. However, evidence shows that 40% of people with RA have some degree of pulmonary fibrosis. RA-linked pulmonary fibrosis symptoms When RA leads to pulmonary fibrosis, people may experience the following:shortness of breathpersistent dry coughfrequent feeling of tirednesssudden, unexplained weight loss These symptoms will occur alongside the more common symptoms of RA, which vary in type and severity and may come and go. During a flare, symptoms can vary in duration and intensity. Common symptoms of RA include:stiffness upon waking up that lasts for 30 minutes or longertenderness, pain, or swelling in the joints that lasts 6 weeks or longerpain in joints on both sides of the bodypain in smaller joints, such as in the hands, wrists, and feet Typically, pulmonary fibrosis and related lung problems develop in people who have lived with RA for several years. This means that doctors usually diagnose RA before pulmonary fibrosis. However, research shows that 10–20% of people can experience symptoms of respiratory issues before they develop typical RA symptoms. Learn more about RA symptoms here. Risk factors for pulmonary fibrosis in RA A person living with RA is more at risk of developing pulmonary fibrosis if they:smokeare maleare an older adulthave a high level of anti-citrullinated protein antibody in their bloodhave a gene that predisposes them to develop the lung conditionoften come into contact with environmental pollutionregularly use anti-inflammatory medication Complications of RA and pulmonary fibrosis Complications from RA-linked pulmonary fibrosis can become life threatening if a person does not receive prompt treatment. Complications include:pulmonary hypertension, which is high blood pressure in the lungspleural effusion, which is a buildup of fluid between the lung and the chest walla collapsed lungrespiratory failureinterstitial pneumonia Diagnosing RA-linked pulmonary fibrosis Typically when a person with RA has lung symptoms, they will need to seek guidance from a rheumatologist and a pulmonologist. Pulmonologists are doctors who specialize in lung conditions. A person may be able to access an evaluation in a multi-disciplinary clinic where different doctors can work together to examine the person and provide a diagnosis. The standard test to diagnose pulmonary fibrosis is a high-resolution CT scan. In addition, a doctor may request one or more of the following tests:bronchoscopy, to rule out infectionpulse oximetrypulmonary function test, which can involve testing how the lungs respond to a short, 6-minute exercisechest X-raylung biopsy, in cases when the doctor wants to exclude lung cancerarterial blood gas test These tests show whether there is inflammation or damage in the lung tissue. They also measure the levels of oxygen, carbon dioxide, and air capacity in the lungs. If a person does not already have a diagnosis of RA, doctors will also ask about the person’s general medical history, do a complete physical examination, and order additional series of imaging and blood tests. These tests check for:swollen jointsthe degree of pain a person is experiencingthe presence of antibodies in the blood called rheumatoid factor (RF) and cyclic citrullinated peptide (CCP)bone and joint abnormalities Common tests to diagnose RA include:RF test: This blood test shows the concentration of RF, an autoantibody common in people with RA.CCP: This blood test checks for another autoantibody common in people with RA.Erythrocyte sedimentation rate (ESR): This test gauges how quickly red blood cells settle to the bottom of a test tube. The ESR test indicates the presence of an inflammatory condition, such as RA, but cannot diagnose RA on its own.C-reactive protein (CRP) test: This test indicates the level of CRP in the blood. Higher levels of CRP may indicate inflammation or infection in the body.Complete blood count: This test can check for anemia. A 2016 study reports that 60% of Sudanese people with RA in the study also had anemia. Treatment for RA and pulmonary fibrosis Both RA and pulmonary fibrosis have no cure, so treatment goals aim to manage the symptoms and reduce the progression of the condition. Medications and treatments to manage RA-linked pulmonary fibrosis may include:anti-inflammatory medicinescorticosteroids and immunosuppressantsoxygen therapy, to provide relief and enable easier breathingpulmonary rehabilitation therapylifestyle changes, such as quitting smoking and increasing physical activity to strengthen the lungs Frequently asked questions When should I contact a doctor If a person with RA has shortness of breath or dry cough, they should seek immediate medical attention. A doctor will typically recommend regular lung screenings to any person with RA. In people with confirmed lung disease, screenings will need to continue every 3–6 months to monitor the symptoms. A person may undergo screening annually if their symptoms are stable. What is the life expectancy for RA-linked pulmonary fibrosis According to a 2016 study, life expectancy for someone with primary pulmonary fibrosis is 2.5–5 years. However, this is merely an estimate based on large-scale population studies. A 2021 study notes that 50% of people died within about 8 years. In the study, the mortality rate was highest in women between 60 and 75 years of age. However, RA-linked pulmonary fibrosis may not follow the same course that aggressive primary pulmonary fibrosis usually does. Also, there is not enough data to estimate the specific outlook for this specific subset of the condition. Outlook RA-linked pulmonary fibrosis progresses differently from person to person. Some people experience worsening symptoms within months, while in others, the condition may take a few years to advance. Differences in progression may be because age, genetics, and lifestyle factors play a role in the development of both conditions. If a person has RA and experiences lung problems, they should contact a doctor at the earliest opportunity about the nature and frequency of symptoms. Recent advances in medication and treatment have improved both management of symptoms and quality of life in the long term. Last medically reviewed on May 25, 2022RespiratoryRheumatoid ArthritisMedically reviewed by Nancy Carteron, M.D., FACR — By Gillian D'Souza — Updated on June 5, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhy does RA often occur in the joints of the hands?Medically reviewed by Stella Bard, MD Rheumatoid arthritis (RA) is an inflammatory autoimmune condition wherein the immune system attacks the lining between the joints. 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