How Can Rheumatoid Arthritis Affect Lungs?

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Rheumatoid arthritis (RA) is a kind of joint disease. But although it primarily affects the joint, it can affect other parts of the body such as heart, eyes, and even lungs. That’s why it is also often called as a systemic inflammatory condition.

Understanding the complications of RA in general

Since RA can be systematic, there is a chance for the inflammation to spread and target other organs. RA itself is often considered as unusual arthritis because it is rheumatoid condition. In other words, it is linked to the abnormality of the patient’s immune system.

image_illustration296Lung is not the only one of distinct organ that can be affected by RA. It also can affect the eyes, heart, mouth, kidneys, liver, blood cells (causing either anemia or low white blood cell count), blood vessels, and even nervous system.

The most common complication of poorly-controlled RA may be joint damage. Each flare poses the risk of damage to the joint. Therefore, the goal of the treatment is to reduce the number of the flares.

More flares of RA, the greater risk to develop the complications from the disease. It seems that poorly-controlled the disease is the key for the complications to occur.

Furthermore, the complications are more likely to occur in patients who have had moderate-to-severe rheumatoid arthritis for a long time.

How can RA affect the lungs?

Lung diseases could be the problem inside the lung itself or a consequence of poorly-controlled other health conditions. In general, some experts believe that there are two major reasons of why lungs can be affected by lots of peripheral disorders:

  1. Frist, we all agree that lung is the essential filter organ. It has crucial function to filter the air when we take a breath. In other words, it is the first organ getting exposed to any harmful things in the environment.
  2. The second reason, lungs receive the whole cardiac output of the blood supply. So if there is an infection or something goes awry with immune system – lungs are vulnerable to be affected, too.

But the exactly answer of why and how rheumatoid arthritis affects the lung are not fully understood yet!

Lung problems are one of common complications from poorly-controlled RA. And there are numerous ways of how this kind of arthritis affects the lungs. A group of lung diseases related to RA is medically called as rheumatoid lung disease.

Pleural effusions

People with RA are at high risk of having fluid accumulation outside the lung. It may be not a large amount of fluid buildups, but it can be large enough to impair the function of the lungs.

Pleura are tissues that surround the lungs. In people with advanced RA for a long time, these tissues can become inflamed.

Some fluids are required to lubricate the pleura’s surface. But the inflammation of pleura may trigger fluid accumulation between layers of pleura, causing pleural effusions.

The diagnosis for this complication is not easy since it can be confused with other health conditions such as cancer or infection. But with fluid analysis, elimination process, and the general condition of patient – the clearly diagnosis can be made.

Interestingly, it may not cause any symptom. But if it does cause symptoms, these may include; rapid breathing, hiccups, fever, cough, and shortness of breath.

Scarring and inflammation within the lungs

Another common RA-related lung disease would be involvement of the tissues or substances of the lung itself.

In this scenario, there is a few different ways of how RA affects the lung. One of them is interstitial lung disease (ILD), a large group of lung disorders which most of which lead to progressive scarring of lung tissue.

Autoimmune disorder (such as RA and lupus) is one of possible causes. ILD also can be caused by some environmental factors, the use of certain medications, or even most cases come with unknown cause.

Difficulty breathing and dry cough are the symptoms of ILD related to RA. But many times, this complication doesn’t cause any symptom.

Pulmonary fibrosis, irreversible condition that causes scarred & thickened tissues around alveoli in the lungs, can affect people with RA, too. It can be a complication of prolonged ILD. It may also occur due to the side effect of some medications for RA, such as methotrexate.

Symptoms such as dry cough and shortness of breath can be found in pulmonary fibrosis related to RA. Other possible symptoms are weight loss, fatigue, muscle & joint aches.

Pulmonary hypertension

It is a condition of when the blood pressure inside arteries that line from the heart to the lung increases higher than normal, causing some problems to the function of both the heart and lungs.

RA can independently increase the risk of hypertension (high blood pressure). It also has contribution to trigger other risk factors for heart problems, such as atherosclerosis and less mobility (the risk of obesity). All these things may lead to pulmonary hypertension!


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