Interstitial lung disease in rheumatoid arthritis remains a challenge for clinicians

Abstract

Rheumatoid arthritis (RA) is a systemic inflammatory disease primarily affecting synovial joints with possible involvement of other organs. It is most often diagnosed in the fourth and fifth decades of life, and women are affected three times as often as men. The lung is a common site of extra-articular disease. Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is one of the most feared manifestations and causes serious morbidity and increased mortality [1–3]. Rheumatoid arthritis is the most common of the connective tissue diseases, and a substantial number of patients with RA will consult general practitioners, rheumatologists, and pulmonologists with respiratory symptoms which, in some cases, may be caused by ILD. Evaluation of respiratory symptoms in patients with RA is challenging because of the many potential causes to be considered including ILD, chronic obstructive pulmonary disease (COPD), bronchiectasis, respiratory infections following immunosuppressive therapies, drug-induced pulmonary toxicity, and ischemic heart disease [4]. The aim of the present review was to provide an overview of epidemiology, diagnostics, treatment, and prognosis in RA-ILD.