Rheumatoid lung disease is a disease of the lung associated with RA, rheumatoid arthritis. Rheumatoid lung disease is characterized by pleural effusion, pulmonary fibrosis, lung nodules and pulmonary hypertension. Common symptoms associated with the disease include shortness of breath, cough, chest pain and fever. It is estimated that about one quarter of people with rheumatoid arthritis develop this disease, which are more likely to develop among elderly men with a history of smoking.Rheumatoid lung is separate from but often associated with Interstitial lung disease(ILD). Signs and symptoms
Most common:

Chest Pain
Cough
Fever
Shortness of breath
Joint pain, stiffness, swelling
Skin nodulesPeople may not present with all these symptoms or none at all. From most to least common:

Pleural involvement (pleurisy, effusions)
Pulmonary parenchymal nodules, more common in men than in women
Rheumatoid-associated interstitial lung disease
Bronchiolitis obliterans organizing pneumonia
Obliterative bronchiolitis (obstructive lung disease/bronchiectasis)
Rheumatoid-associated pulmonary hypertension
Pulmonary vasculitis/arteritis
Shrinking lung syndrome
Miscellaneous: MTX, cricoarytenoid arthritis, infection, cancer

Causes
The exact cause of rheumatoid lung disease is unknown. However, associated factors could be due largely to smoking. Sometimes, the medicines used to treat rheumatoid arthritis, especially methotrexate, may result in lung disease.Prevention:

Stop smoking: Chemicals found in cigarettes can irritate already delicate lung tissue, leading to further complications. Having regular checkups: The doctor could listen to lungs and monitor breathing, because lung problems that are detected early can be easier to treat. Mechanism
RA is a complex and poorly understood disease. However, the characteristic presence of antibodies to citrullinated proteins (anti-CCP) suggests that there are pathogenic mechanisms unique to RA. Recent studies suggest a link between smoking, HLA-DRBSE, anti-CCP and RA.
The affected lung, which has a great deal of elastic tissue, shrivels in what is referred to as a collapsed lung. Diagnosis
If you have an injury or trauma to your chest, your doctor may order a chest X-ray to help see if fluid or air is building up within the chest cavity. Other diagnostic tests may also be performed to further evaluate the fluid in around the lungs, for instance a chest CT scan or an ultrasound. An ultrasound of the chest will show the amount of fluid and its exact location. Treatment
Treatment for this condition is the same as for hemothorax and pneumothorax independently: by tube thoracostomy, the insertion of a chest drain through an incision made between the ribs, into the intercostal space. A chest tube must be inserted to drain blood and air from the pleural space so it can return to a state of negative pressure and function normally.Commonly, surgery is needed to close off whatever injuries caused the blood and air to enter the cavity (e.g. stabbing, broken ribs). See also
Catamenial pneumothorax
Tension pneumothorax
Pulmonary contusion

References


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