Pulmonology specialist Dr Sonal Jagtap explains lung changes in rheumatoid arthritis.
Rheumatoid Arthritis is a disease in which the body’s immune system – which normally protects its health by attacking foreign substances like bacteria and viruses – mistakenly attacks the joints. There is 50% chance that this disease can, at the same time, involve the lungs.
The lung problems most often linked to rheumatoid arthritis include
- Scarring within the lungs. Scarring related to long-term inflammation (interstitial lung disease) may cause shortness of breath, chronic dry cough, fatigue, weakness and loss of appetite.
- Lung nodules. Small lumps can form in the lungs (rheumatoid nodules), as well as in other parts of the body. Lung nodules usually cause no signs or symptoms, and they don’t pose a risk of lung cancer. In some cases, however, a nodule can rupture.
- Pleural disease. The tissue surrounding the lungs, known as the pleura, can become inflamed. Pleural inflammation is often accompanied by a buildup of fluid between two layers of the pleura (pleural effusion). Sometimes the fluid resolves on its own. A large pleural effusion, however, can cause shortness of breath. Pleural disease may also cause fever and pain on breathing.
- Upper Airway disease: The joint of the throat (cricoarytenoid) may get involved, causing difficulty with inspiration and occasionally resulting in stridor. A sore throat and hoarseness are other common complaints.
- Lower Airway Disease : (Bronchiolitis obliterans) The small air pipes of the lungs may get inflamed causing progressive breathing difficulty and cough
Unfortunately some of the medications used for the treatment of the condition themselves can cause certain side effects that may damage the lungs.
Overall, the above mentioned lung complications are usually manifestation of untreated or not well treated condition. An association between smoking and risk of development of lung complications due to rheumatoid arthritis have been reported.
How to deal with these changes?
- Do not neglect your body’s needs and demands. Follow-up with the experts to assess your joint pains. Keep regular checks on any symptoms involving the lungs. There are different tests and investigations that may be appropriately advised for your various symptoms.
- Radiological investigations including CT scan of the lungs may detect the exact underlying structural lung changes. Spirometry or lung function tests can detect changes in the functional capacity of the lungs. Early reversible changes can be treatable.
One must remember to discuss all treatment options with the physician, weighing the benefits and side effects of the medications used to treat the rheumatoid arthritis.
Dr. Sonal Jagtap
Bahrain Specialist Hospital