What Are The Presenting Features Of Rheumatoid Lung Disease & How Is It Treated?

What is Rheumatoid Lung Disease ?

Rheumatoid Lung Disease is the name given to a collection of lung disorders that arise as a result of rheumatoid arthritis. It is well known that rheumatoid arthritis affects the various joints of the body but it has also been proved that this condition also can affect the lungs to an extent that it can cause inflammation and scarring of the lung tissues. In some cases there may also be lung nodules as a result of rheumatoid arthritis. It is well known that rheumatoid arthritis is an extremely disabling and painful condition in which both genetic and environmental factors play a role. Around 1% of the general population suffers from rheumatoid arthritis according to various studies. It severely impacts the quality of life, functional ability, and overall survival of the affected individual.[1]

Apart from affecting the joints, pulmonary involvement of this condition also plays a crucial role in determining the morbidity and mortality of people with rheumatoid arthritis. In fact, pulmonary complication is quite common in people with rheumatoid arthritis. This condition can affect the pleura, airways, and the parenchyma causing inflammation and scarring. As of recently, rheumatoid arthritis associated interstitial lung disease has come up as one of the most common complications of rheumatoid arthritis. There is not much data available in the literature to study the actual impact of rheumatoid arthritis associated lung disorders.[1]

What is Rheumatoid Lung Disease ?

What that can be understood is that lung tissue scarring associated with rheumatoid arthritis significantly impair the survival rate and overall quality of life of the patient. This article highlights the presenting features of rheumatoid lung disease and ways to manage this condition.[1]

What Are The Presenting Features Of Rheumatoid Lung Disease?

The presenting features of Rheumatoid Lung Disease are quite variable and depend on how rheumatoid arthritis has affected the lungs. In cases where nodules develop in the lungs as a result of rheumatoid arthritis then the patient may be completely asymptomatic. However, in other situations, especially when scarring of the lung tissues occur then the patient can experience significant symptoms to include problems with breathing, severe weakness, and poor appetite.[2]

The individual will also have persistent bouts of dry cough without any phlegm production. Due to poor appetite, the patient will tend to lose significant amount of weight. The individual will also be fatigued and lethargic and will find basic activities difficult to do.[2]

How is Rheumatoid Lung Disease Treated?

Coming to the treatment options, the approaches are variable and depend on the symptoms experienced by the patient and the extent of the damage done to the lungs. As an example, if rheumatoid arthritis has affected the pleura and caused pleural effusion then the treatment will involve drainage of the fluid to clear the pleural space.

Treatment is not required for lung nodules that develop as a result of rheumatoid arthritis.[2]

For inflammation and scarring that occurs as a result of rheumatoid arthritis physicians will give treatment even though the scarring is permanent and cannot be reversed. The treatment will be aimed at reducing the symptoms and delay the progression of the disease. To treat the scarring of the lungs caused due to Rheumatoid Lung Disease, the physician may recommend the following[2]:

Medication: Physicians used to treat the scarring of the lungs with medications which decreased the inflammation and suppressed the immune system. However, the latest research states that the efficacy of such medications is questionable.[2]

Pulmonary Rehabilitation: This is perhaps the best way to improve breathing and quality of life of people with Rheumatoid Lung Disease who have scarring of the lung tissues. A pulmonary rehabilitation program involves teaching the patient breathing exercises such that they are able to control breathing and are able to do more activities without any problems.[2]

However, due to the stiff and painful joints due to rheumatoid arthritis some people find it difficult to do any exercises which make this program less effective than normally in people with Rheumatoid Lung Disease.[2]

Oxygen Therapy: Some people with severe problems with breathing and who are unable to practice breathing exercises are given supplemental oxygen to assist in breathing. This is also quite effective in improving symptoms caused due to Rheumatoid Lung Disease.[2]

Lung Transplant: This is the last resort that physicians go for. This is especially in cases where the individual has severe interstitial lung disease caused by rheumatoid arthritis. It is a long and tedious process to get qualified for a lung transplant and not everyone is deemed to be a candidate for this procedure.[2]

In conclusion, Rheumatoid Lung Disease refers to the complications that develop in the lung as a result of rheumatoid arthritis. It is well known that rheumatoid arthritis affects the joints but this condition also quite often affects the lungs. Rheumatoid arthritis can cause significant damage to the lungs by causing scarring of the lung tissues which is an irreversible condition. It may also cause nodules to develop in the lungs.[1, 2]

The presenting features of Rheumatoid Lung Disease vary depending on the extent of the damage to the lungs. It may include problems with breathing along with poor appetite and unintentional weight loss. The treatment again for Rheumatoid Lung Disease is variable and depends on the damage caused to the lungs due to Rheumatoid Lung Disease. While medications and pulmonary rehabilitation program are quite often use to treat the symptoms of Rheumatoid Lung Disease, the efficacy of such treatment options are questionable.[2]

Lung transplant is also a treatment option but not many people are deemed to be a candidate for it. The overall prognosis of Rheumatoid Lung Disease is quite variable and depends on the severity of the damage to the lungs. People with lung scarring and RA associated interstitial lung disease have a poor prognosis as these conditions are irreversible. Studies suggest that average survival rate for such patients ranged from 3 to 8 years from the time of initial diagnosis.[2]

Prognosis of Rheumatoid Lung Disease

The prognosis also gets affected as the condition progresses and more severe complications develop due to Rheumatoid Lung Disease. It is quite common for people with Rheumatoid Lung Disease to have lung complications and it is something which cannot be prevented. However, making lifestyle changes like eating a balanced diet, exercising, and abstaining from smoking may delay the progression and of the disease and may even reduce the risk of developing Rheumatoid Lung Disease to a certain degree.[2]

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