Symptoms Of Rheumatoid Arthritis In The Lungs
Symptoms of rheumatoid arthritis in the lungs vary a little, depending on the variation and severity, but broadly speaking these will include
- Painful Breathing
- Chronic fevers
When Should I See A Doctor?
The simple answer is as soon as you experience any of the above symptoms, especially if you already have rheumatoid arthritis. With any from of arthritis, and especially rheumatoid arthritis time is key.
Dont be afraid to waste your doctors time if you experience pain breathing or any difficulty whatsoever, it is always best to get it checked out. It might just save your life.
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The Role Of Methotrexate In Rheumatoid Arthritis
Much has been made of the association between MTX and RA-ILD over the past few decades. While there is an association with MTX and RA-ILD, it is now known to be coincidental and not causative, with the underlying inflammatory process driving ILD. In short, it is the disease and not the drug that causes RA-ILD.62
An Immune System Weakened By Ra Treatments
When I was diagnosed and started the immunosuppressant medications, mostly Orencia, my sinus infections came back full force. If I was lucky, I only felt pressure in my head for a few days before the issue corrected itself . If I was unlucky, I got the gamut of symptoms and took antibiotics.
Over the last eight years, Ive been relatively lucky only relying on antibiotics but starting this Fall 2018 I ran into a problem. I began to feel constant pressure in my head. My nose dripped continuously and occasionally Id get the acute infection. Initially, I thought Id just take the antibiotics but they didnt help. It wasnt until my balance was affected that I saw a new doctor.
I had a CT scan . I have an acute infection and it turns out a slightly deviated septum. It is almost completely straight which on its own wouldnt be an issue except the turbinate bones are inflamed and the left one is pushing against my septum. This is causing a mild blockage that is impeding my breathing and draining abilities. Adding a tiny bit of fuel to the fire is my nasal cartilage is weak and collapses every time I breathe.
Well, I guess it wasnt just my chronic sinusitis. I just dont have the anatomy to keep myself healthy!
I am on antibiotics and a steroid nasal spray. I irrigate my sinuses twice a day. I am all set to have a balloon dilation. Later , I hope to get the septum repaired, along with treating the turbinate bones and adding a little support to the cartilage.
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Host Mechanisms For Developing Autoimmunity In The Lung: Inducible Bronchus Associated Lymphoid Tissue
As discussed, inhaled environmental factors such as smoking and/or bacteria may be involved in mechanisms of generation of autoimmunity in RA. Yet, it is unknown how these factors may directly interact with the immune system at the cellular level to generate RA-related autoimmunity in the lung. However, inducible bronchus associated lymphoid tissue is one possible mechanism based on its immunologic features and associations with RA.
What Is The Outlook For Patients Living With Ra
RA research has come a long way over the past several decades. Historically, little was known about RA and the wide-ranging symptoms and complications which resulted from the diseases inflammatory processes.
Today, doctors understand that there are several conditions that may present themselves in RA patients. Patients who work closely with their rheumatologist can have these potential complications addressed early on, and pursue appropriate treatments to prevent symptoms from advancing.
Despite working proactively with medical specialists, there are cases where patients suffer from severe symptoms which do not respond to current treatments. Unfortunately these cases can lead to a shortened life expectancy.
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
What Determines Life Expectancy
RA is an autoimmune disease that makes patients more susceptible to developing other conditions. This can compromise the health of patients long-term. That being said, there are factors that can improve a patients life expectancy through mitigating the complications experienced during the disease course.
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What Is The Average Ra Life Expectancy
Studies have found an association between RA and a shortened lifespan. This is different than saying that RA itself causes a premature death. The complications that develop as a result of an aggressive RA disease course are what put patients at a greater risk for a lower life expectancy.
An exact life expectancy is almost impossible to predict due to the varying nature of the disease. In general, patients can expect that the rheumatoid arthritis life expectancy could be shortened by roughly 10 years to as many as 15 years. This is dependent on a number of factors including but not limited to:
- Personal and family medical history
- Overall levels of health and wellbeing
Do not lose hope! Despite these study results, its also important to note that many RA patients live well into their 80s and 90s which is an average expected lifespan.
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.
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How To Help Keep Your Lungs Healthy
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.
Lung Disease Is Highly Prevalent In Clinically Classifiable Ra
While the joints are the predominant organs targeted by immune and inflammatory responses in RA, other tissues can be affected as well. This review will focus on pulmonary involvement in RA, but extra-articular involvement in RA can additionally include cutaneous, ocular, cardiac, neurologic and hematologic manifestations .
In order to understand the types of lung disease that can be present in RA, differences should be considered between anatomic compartments of the lung including the airways, parenchyma, pulmonary vasculature and the pleura . The airways of the lung are defined as the passageways through which air moves in the lung and include the bronchi, bronchioles and terminal bronchioles . The lung parenchyma is defined as the functional tissue involved in gas transfer that includes the alveoli, and the interstitium between the alveoli and lung capillaries. The lung vasculature includes the pulmonary arteries and veins that carry blood for gas exchanges as well as the smaller bronchial arteries and capillaries that nourish the airways, lung tissue and alveoli. Because the pulmonary vasculature is a key component of gas exchange, it is sometimes considered to be a part of the lung parenchyma. However, clinical disease affecting the pulmonary vasculature is distinct from ILD therefore, herein, pulmonary vascular involvement will be considered separate from parenchymal lung involvement. Finally, the lung pleura is the thin membranous lining surrounding the lung.
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Types Of Pulmonary Involvement
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
The Cardiac Risks Of Rheumatoid Arthritis
As if the chronic pain and mobility challenges of rheumatoid arthritis werent burdensome enough, its becoming clearer that people with the disease face another serious health threata greater risk for heart disease.
Some 1.5 million Americans, a majority of them women, have this form of arthritis, an autoimmune disease that happens when the immune system attacks the bodys own tissues, causing pain, swelling, stiffness and loss of function in the joints.
Doctors have long known that people with rheumatoid arthritis and related conditions had a shorter lifespan than those without these conditions. Data suggest that heart disease may explain this discrepancy. In fact a review of studies in the journal Nature Reviews Rheumatology suggests that more than 50 percent of premature deaths in patients with rheumatoid arthritis result from cardiovascular conditions.
The link between the two diseases: inflammation. In people with rheumatoid arthritis, the immune system attacks the synoviumthe lining of the membranes around the joints. This causes the synovium to thicken, eventually damaging the cartilage and bone.
But the process doesnt stop at the joints. The inflammation can damage systems throughout the body, including the skin, eyes, lungs, and heart. Inflammation narrows the arteries, raising blood pressure and reducing blood flow to the heart, for instance.
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Keep A Check On The Progression Of Your Disease
RA is a progressive, degenerative disease which over the years can cause severe damage to your various vital organs, including lungs. To prevent the acute damage that RA can cause, it is important to keep a close check on the progression of the disease. So, watch out for all the signs of rheumatoid arthritis and immediately get in touch with your primary care physician if you experience persistent cough, shortness of breath, fever or any other health complication.
Medication And Treatment For Ra
More research is still needed to find effective treatment. According to research published in the journal European Respiratory Review, an analysis of various studies looked at the drug Rituxan for the treatment of RA-ILD, but the results were conflicting and its not clear whether it improves or worsens the condition.
Some other drugs, like mycophenolate mofetil, azathioprine , cyclosporine , and cyclophosphamide , are used to treat RA-ILD. A new class of drugs called antifibrotics has been used in people with other types of fibrotic lung diseases, or diseases involving lung scarring or damage. Research is ongoing to determine whether these drugs should be used in patients with RA-ILD.
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The Direct Effects Of Rheumatoid Disease On Lung Tissue And Pleura
People with RA can develop disease in their lungs, as a consequence of their immune system attacking their joints and other tissues. Different types of lung disease can occur, including interstitial lung disease , bronchiectasis and bronchiolitis obliterans. In each of these, inflammation and damage can occur to the lung tissue, reducing the ability to absorb oxygen from the air we breathe into the bloodstream and causing breathlessness in affected people. Often this is accompanied by a persistent cough, especially with exertion. Breathing tests and a CT scan of the lungs are used to confirm the diagnosis, and precise patterns of lung disease are described.
Mechanisms That May Be Involved In The Generation Of Ra
The above findings of lung disease, and in particular airways disease prior to the onset of joint inflammation in RA, and the generation of RA-related autoantibodies in the lung, strongly suggest that the lung is a site of initiation of RA-related autoimmunity. However, if this is the case, what is driving the generation of that autoimmunity?
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Do You Have Rheumatoid Arthritis
Around 1.5 million people in the U.S. have RA, and about 70% of them are women. It usually begins between ages 30 and 50, but it can happen at any age.
Experts arent sure what causes the immune system to overreact in RA. A working theory is that some people are more likely to get it for genetic reasons, and then they are exposed to certain things in the environment that trigger it.
RA causes inflammation in the fluid and tissue around the joints . This initially causes pain and swelling. Over time, it damages the cartilage and the bones themselves. This damage which is irreversible leads to decreased motion, pain, and deformity of the joints.
RA commonly begins in the small joints, which are in the hands, feet, and wrists. That said, it can also affect other larger joints, including the elbows, ankles, and knees. Symptoms in these joints include:
RA can also cause inflammation in other parts of the body. That means other symptoms can include:
A general sense of not feeling well
Up to 50% of people with RA will have effects in areas other than joints at 10 years after diagnosis. When RA affects your organs, it can lead to:
Nodules under the skin near affected joints
Dry eyes and mouth
Nodules From Rheumatoid Arthritis In Lungs
These firm bumps of tissue, or rheumatoid nodules, might form in the lungs. They dont typically cause symptoms, nor do they pose a risk for lung cancer. Nodules range in size from a millimeter to centimeters in size, there may be one or a bunch, and they may come and go over time. In some cases, however, a nodule can rupture and caused a collapsed lung.
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Limit Your Exposure To Pollutants And Chemicals
There are various chemicals and pollutants in the air that increase the oxidative stress in the body, causing inflammation which, in case of RA, is detrimental both for your joints and lungs. Thats why, patients with RA should limit their exposure to pesticides, airborne chemicals, pollutants and more.
Be Aware Of Possible Ra Drug Risks And Side Effects
Some RA drugs are immunosuppressive and may cause infections in the lungs. No one really knows for sure how treatment for RA affects the lungs, either positively or negatively. Patients are encouraged to talk with their provider to make sure that the medications are optimal for their joint symptoms and their lung health, says Sparks.
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Rheumatoid Arthritis In The Lungs
Rheumatoid Arthritis Is More Than A Joint Disease
The lungs may seem an unusual area to be attacked by Rheumatoid Arthritis after all RA is a disease known to attack joints.
However, lung disease is the 2nd most common cause of death from Rheumatoid Arthritis so here we review everything you need to know about Rheumatoid Arthritis in the lungs.
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Additional Factors Suggesting Ra
Exposure to tobacco smoke has long been associated with increased risk for development of clinically classifiable RA as well as RA-associated lung disease . In addition, recent studies of subjects with smoking associated chronic airways disease, specifically chronic obstructive lung disease , without joint inflammation have identified an increased prevalence of serum ACPA positivity further supporting that the lung may be a site of generation of RA-related autoimmunity . Specifically, Ruiz-Esquide and colleagues evaluated subjects without RA who had a heavy smoking history and COPD, and in these subjects, they found a higher prevalence of serum ACPA positivity compared with controls without a history of smoking .
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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.