Rheumatoid arthritis: Can it affect the lungs?

Yes. Although rheumatoid arthritis primarily affects the joints and surrounding tissues, it can also affect the lungs in several ways. However, lung involvement is uncommon — occurring in only about 5 percent of people with rheumatoid arthritis. Lung disease associated with rheumatoid arthritis may include:

• Pain with breathing (pleurisy). Rheumatoid arthritis can cause inflammation of the lining (pleura) of the lungs, resulting in painful breathing. Fluid due to inflammation may also accumulate around the lungs (pleural effusion), which causes shortness of breath. Treatment is directed at the underlying rheumatoid arthritis. If pleural effusion occurs, treatment may include removing the fluid from the lungs.
• Lung nodules (rheumatoid nodules). Rarely, small lumps (nodules) may form in the lungs. These nodules are often associated with widespread joint involvement and rheumatoid nodules on other parts of the body. Lung nodules usually cause no signs or symptoms. Rarely, a nodule may rupture through the pleura, causing the lung to collapse (pneumothorax).
• Scarring of the lungs (pulmonary fibrosis). Rheumatoid arthritis can lead to scarring of the connective tissue, which supports the air sacs (alveoli) in the lungs. The main symptom is shortness of breath. Treatment may include immunosuppressive medications such as corticosteroids.

The cause of lung disease associated with rheumatoid arthritis is unknown. Sometimes medications used to treat rheumatoid arthritis may result in lung disease. Consult your doctor promptly if you have rheumatoid arthritis and experience any unexplained breathing problems.