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Can Rheumatoid Arthritis Affect The Lungs

Are Rheumatoid Arthritis Symptoms Serious

5 Pulmonary Manifestations of Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that causes the immune system to attack the joints. In people with rheumatoid arthritis, the immune system mistakenly attacks the joints in the hands and feet. Rheumatoid arthritis symptoms include pain and stiffness in the hands, wrists and other joints. There are also chronic inflammatory symptoms, which can include swollen hands and feet. People with rheumatoid arthritis can also develop severe arthritis and sometimes, severe joint problems. There are many different types of rheumatoid arthritis, but one of the most common is RA-Infectious Polyarthropathy . RA-IIA occurs in about 5% of people with RA. People with RA-IIA experience inflammation that spreads to other parts of the body. This can cause joint problems such as arthritis, which can become painful and difficult to walk.

Limit Exposure To Pesticides Airborne Chemicals And Air Pollution

There seems to be a tight connection between the lungs and joints in RA, so it’s very important to eliminate inhalants, such as pesticides, airborne chemicals, and air pollution, as much as possible. Most of the research has focused on the detrimental effects of cigarette smoking on both the joints and lungs, but it makes sense that the others are likely unhealthy as well, says Sparks.

Ways To Stay Healthy While Living With Rheumatoid Arthritis

Making sure to eat healthy foods and avoiding foods that contain high amounts of sugar and fat to keep your inflammation levels down.

A Mediterranean diet is good because it is low in saturated fat. It is low in red meat and processed food such as fried chicken or french fries.

Eating plenty of antioxidants like those found in berries, cherries and leafy greens can help with inflammation as well.

Some people find that adding certain spices to their diets helps too! Ginger, turmeric, cumin, and garlic are all good options for infusing flavor into your favorite dishes without the calories or sugar content from other foods.

Getting up and moving as much as possible. Exercising at least 30 minutes a day, five days per week.

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Several Other Lung Complications May Occur

People living with rheumatoid arthritis also face a heightened risk of:

  • Bronchiectasis, or damage to the airways
  • Bronchiolitis obliterans, or inflammation in small bronchial tubes
  • Pleural effusion, a buildup of fluid between the lung and chest wall
  • Pleurisy or pleuritis, or inflammation of the lining of the lung and chest wall
  • Pulmonary hypertension, high blood pressure in the lungs

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How To Help Keep Your Lungs Healthy

How Rheumatoid Arthritis Affects the Lungs

After heart disease, lung disease is the second-most common cause of death in rheumatoid arthritis. To help protect your lungs follow these three steps:

1. Quit smoking. Its harmful to your health in a million different ways. And the chemicals in cigarettes can irritate lung tissue even more. To get help, talk to your doctor or go to smokefree.gov. Quitting smoking can also help you achieve remission for your arthritis.

2. Get vaccinated. Respiratory infections are common infections in RA, and complications could be severe. There are two types of pneumonia vaccines talk to your doctor about which ones you need and when you should get them. The annual flu shot is another must. Heres what you need to know about getting the flu vaccine when you have arthritis.

3. Report any breathing problems to your doctor. Regular check-ups are important so your doctor can monitor your lungs. But be sure to tell your physician right away if you experience shortness of breath, consistent coughing, or other respiratory symptoms. Lung issues that are detected earlier may be easier to treat.

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Stomach Pain Or Indigestion

RA and medicines used to treat it are linked to mouth and stomach ulcers, stomach bleeding, acid reflux, diarrhea, and constipation. Painful diverticulitis and colitis are also possible if you have RA.

RA drugs like NSAIDs often cause ulcers or an upset stomach.

Belly pain is sometimes a sign of a rare RA complication called rheumatoid vasculitis when inflammation spreads to your blood vessels. Weight loss and lack of appetite are other symptoms. Vasculitis is serious, so see a doctor right away. Learn more about vasculitis symptoms and types.

How Does Arthritis Affect You

Arthritis is a condition that involves the inflammation of joints. It can be caused by a number of conditions such as an injury, infection, or autoimmune disease. Rheumatoid arthritis is an autoimmune disease that causes inflammation of joints and connective tissue. Its the most common form of arthritis and typically occurs in people over the age of 40. Symptoms of rheumatoid arthritis include pain, stiffness, and swelling in the joints. Sometimes, the joints can become red, swollen, and hard. Rheumatoid arthritis is a chronic condition that causes progressive joint damage and disability. There is no cure for arthritis. However, there are treatments that can help ease some of the symptoms.

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How Does Treatment Improve Life Expectancy

Early treatment greatly improves the prognosis of RA patients. If treatment begins before symptoms cause too much damage, patients can generally go on to live a better quality of life.

Ongoing treatment and monitoring can help rheumatologists provide the most appropriate and personalized care for their patients. Each patient will experience a different set of symptoms over their lifetime. Doctors look for warning signs of other complications associated with RA and work to either prevent them or treat them as they develop.

The main goal of treatment is to reduce pain and improve quality of life. Many patients experience very effective treatment plans and continue to live their lives making appropriate lifestyle adjustments along the way.

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When Should I Contact A Doctor

Rheumatoid Lung Disease

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 to monitor the symptoms. A person may undergo screening annually if their symptoms are stable.

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Types Of Rheumatoid Lung Disease

The most common manifestation of pulmonary disease in rheumatoid arthritis is interstitial lung disease , a condition that causes inflammation and scarring of the lungs. Once lung tissue scars, it no longer functions.

The most frequent forms of interstitial lung disease are usually interstitial pneumonia and nonspecific interstitial pneumonia. Another presentation combines pulmonary fibrosis and emphysema.

Get Early Treatment For Ra

We are still working to understand the natural history of lung involvement in RA and how exactly medication may be involved. At this point, I would encourage early screening for lung involvement for patients with signs and symptoms, says Sparks. If you have RA and are experiencing shortness of breath, coughing, or other respiratory symptoms, talk to your doctor. These are potentially serious symptoms that warrant prompt attention.

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Symptoms Of Pain Behind The Ear And Down The Neck

Pain down the neck and behind the ear is not a condition in itself. Ear and neck pain are usually symptomatic of other health issues and will usually be accompanied by other symptoms. For example, an ear infection can cause neck pain behind the ear on one side of your head and could be accompanied by swelling or discharge from your right or left ear.

Associated symptoms of pain behind the ear and neck can include:

  • Throbbing pain in the neck and on one side of your head
  • Shock-like pains at the top of your neck and behind your ear
  • Redness of the ear or behind the ear that is sore to touch
  • Soreness when turning your head from side to side
  • Intense pain from your jaw that extends behind one ear
  • An aching toothache that radiates pain to your ear
  • Increased sensitivity to light along with a thumping headache

Congestive Heart Failure Ischaemic Heart Disease And Risk Factors

Interstitial Lung Disease: Symptoms, Risk Factors, and Treatment Options

Several reports showed that the increased incidence of cardiovascular disease, including ischaemic heart diseases, or the presence of carotid atherosclerosis is not explained by traditional cardiovascular risk factors , suggesting that RA-related factors might influence the risk of cardiovascular disease .

The increased prevalence of congestive heart failure found in RA patients is underlined by recent echocardiographic studies. Left ventricular systolic dysfunction has been found to be three times more common than in the general population and was associated with abnormal electrocardiography, suggesting that screening of RA patients with abnormal electrocardiography may be worthwhile . Also, right and left ventricular diastolic dysfunction are found more frequently in RA patients without evident cardiovascular disease .

As the use of several drugs in RA, including corticosteroids and biological therapy, have such an important positive effect in the reduction of arthritis activity and improvement of functional capacity, it is important to have more knowledge on possible deleterious effects on the function of the heart due to these drugs.

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People With Rheumatoid Arthritis Have A Higher Risk Of Developing Infections

People with RA are more susceptible to infections because of the disease itself and increased vulnerability from medications.

The drugs used for treating RA, including methotrexate, an injectable drug that suppresses inflammation in order to reduce joint pain, can cause a defect in white blood cells which helps fight infection and foreign invaders in our bodies.

As well as this, people who have had surgery on joints such as hip replacements or surgeries may need extended time off work due to their impaired ability to move around without causing further damage whilst recovering making them less likely to be able to keep themselves clean and healthy.

The risk is also higher if you smoke tobacco products also increases the likelihood of developing infections.

There are other treatments available including steroids that do not affect your immune system or even stopping some medication altogether.

It is important to visit the doctor if you are experiencing swollen joints, flu symptoms, or fever.

The most common infections that people with RA can develop include:

  • Lung abscesses caused by bacteria and tuberculosis all of which can be fatal as your immune system becomes so weakened it cannot fight off these types of diseases.
  • People with rheumatoid arthritis have an increased risk of developing infections because inflammation may damage white blood cells.

Fortunately, these types of infections also respond well to antibiotics.

Suggested Algorithm For The Assessment Monitoring And Management Of Ra

Figure 6. The proposed algorithm for pulmonary symptoms in RA. ABA, abatacept bDMARD, biological disease-modifying antirheumatic drug csDMARD, conventional synthetic disease-modifying antirheumatic drug ILD, interstitial lung disease MTX, methotrexate MTX-pneu, MTX-pneumonitis RA, rheumatoid arthritis RTX, rituximab TCZ, tocilizumab. MIP Methotrexate-induced pneumonia GCs glucocorticoids.

In conclusion, a comprehensive and multidisciplinary approach is required for differential diagnosis of ILDs, early identification of RA-ILD, and timely intervention on progressive and fibrosing forms. It is especially crucial to contextualize any respiratory symptoms in a given patient with RA. In the setting of a recently introduced MTX treatment, MTX pulmonary toxicity is certainly a concern, particularly if the onset of respiratory symptoms is acute or subacute in such cases, MTX needs to be stopped and high-dose glucocorticoids, along with supportive care, should be timely started. If the onset of respiratory symptoms is instead more insidious, RA-ILD is more likely to occur, and immunotherapies with csDMARDS and/or bDMARDs should be readjusted based on the severity of lung and joint disease and possible comorbidities. Ongoing investigations and future RCTs will better clarify the strategies to be put in place for the optimal management of RA-ILD.

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Scarring Within The Lungs

In medical speak, its called interstitial lung disease a broad category of lung disorders, most of which lead to scarring in the tissue between the air sacs of the lungs . Chronic inflammation from rheumatoid arthritis can lead to this scarring over time, the buildup of scar tissue makes the lung tissue stiff, which interferes with breathing and can be difficult to treat.

ILD is the most common and most serious lung complication for people with RA: Research shows lung disease alone accounts for up to 20 percent of deaths in rheumatoid arthritis patients, and most are attributed to ILD. Though its rare, this scarring may also occur in a small number of people with ankylosing spondylitis.

Symptoms include shortness of breath and dry cough, as well as fatigue and weight loss. But by the time these signs appear, irreversible lung damage has often already occurred. Some estimates suggest about 30 percent of patients with rheumatoid arthritis have ILD, without obvious symptoms.

How Heart Disease Affects People With Ra

Rheumatoid Arthritis Interstitial Lung Disease

Dr. Navarro-Millán is an advocate for coordinated care, in which people with RA get primary care along with seeing a rheumatologist. She emphasized that primary care doctors and rheumatologists need to stay in close communication when risk factors are identified. As rheumatologists, we are really focused on controlling pain, decreasing inflammation, and decreasing and monitoring side effects of medication, Dr. Navarro-Millán said.

But people with RA need to have regular screenings by primary care providers for cardiovascular disease risk factors like hyperlipidemia high cholesterol and high blood pressure. Many of my patients with rheumatoid arthritis say, Well, I dont have anything else but rheumatoid arthritis. Why should I see a primary care provider? And that is where things start to fall through the cracks, she noted.

One myRAteam member described her experience discovering heart problems unexpectedly. I am in the hospital with high blood pressure and a high heart rate, she said. I went to see my rheumatologist and she sent me straight to the emergency room. I dont have a history of heart problems or high blood pressure.

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Ra Flares Can Have Triggers

It is possible for a specific activity or event to initiate a flare-up. The activity or event sets off inflammation in the body that is difficult to stop. A flare may be triggered by:

  • An illness, such as the flu
  • An injury or surgery

Triggers vary from person to person. In addition, not all RA flares have clear triggers.

Interstitial Lung Disease In Rheumatoid Arthritis: A Practical Review

  • 1Asst Ovest MilaneseRheumatology Unit, Magenta Hospital, Milan, Italy
  • 2Asst Ovest MilaneseInternal Medicine Department, Cuggiono Hospital, Milan, Italy
  • 3Asst Ovest MilaneseInternal Medicine Unit, Legnano Hospital, Milan, Italy

Rheumatoid arthritis is a systemic inflammatory disease, which primarily causes symmetric polyarthritis. An extrarticolar involvement is common, and the commonly involved organ is lungs. Although cardiac disease is responsible for most RA-related deaths, pulmonary disease is also a major contributor, accounting for ~1020% of all mortality. Pulmonary disease is a common extra-articular complication of RA. Optimal screening, diagnostic, and treatment strategies of pulmonary disease remain uncertain, which have been the focus of an ongoing investigation. Clinicians should regularly assess patients with RA for the signs and symptoms of pulmonary disease and, reciprocally, consider RA and other connective tissue diseases when evaluating a patient with pulmonary disease of an unknown etiology. RA directly affects all anatomic compartments of the thorax, including the lung parenchyma, large and small airways, pleura, and less commonly vessels. In addition, pulmonary infection and drug-induced lung disease associated with immunosuppressive agents used for the treatment of RA may occur.

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What Role Do Autoantibodies Play In Ra Pathogenesis

Because of these issues, going forward, a deeper understanding of the immune system beyond autoantibodies will be necessary to understand how RA may be initiated in the lung, or other mucosal surfaces, and in particular how an immune response generated at a mucosal site could transfer to another site, such as the joints. Such studies should be facilitated by emerging technologies for studying T and B cells, as well as other aspects of the immune system , in preclinical RA .

Types Of Pulmonary Involvement

Chronic bronchitis is a progressive lung disease that affects the ...

Respiratory symptoms in rheumatoid arthritis can be due to a variety of conditions that affect the parenchyma, pleura, airways or vasculature . Complications may arise directly from rheumatoid arthritis involvement or may occur secondary to immune-modulating medications used to treat rheumatoid arthritis. The majority of respiratory manifestations occur within the first 5years of disease . Respiratory symptoms may precede onset of articular symptoms in 1020% of cases . However, they may be masked by poor functional status from joint disease or chronic inflammation.

Pulmonary manifestations of rheumatoid arthritis

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Heart And Blood Vessel Disease

Pericarditis, or inflammation of the membrane that surrounds your heart, usually develops during flares. Flares are times when your RA is worse.

If it happens a lot, pericarditis can make the membrane thicker and tighter. That can interfere with your hearts ability to work the way it should.

Rheumatoid nodules can also form on the heart and affect the way it works.

Inflammation of the heart muscle itself, called myocarditis, is a rare complication.

Rheumatoid arthritis can make you more likely to get cardiovascular disease. It also raises your risk of stroke. This is probably related to long-term inflammation.

Heart disease doesnt always have symptoms before a crisis. Your doctor can spot some problems during a checkup and may recommend lifestyle changes or medication.

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Easing Pain And Other Symptoms Of Costochondritis

Some people find relief by splinting the chest using an Ace wrap or something similar to try to minimize chest movement, he says. But there really is no great way to treat it, outside of time, says Gewanter.

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Theres also no real way of knowing how long the pain will last, though the American Family Physician report says that it can last from weeks to months, though for some it may last for a year. Patients with costochondritis should be educated and reassured that this is a benign condition that will eventually resolve itself, the journal states, sometimes without any treatment at all.

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