20th February 2025

Rheumatoid arthritis

RA can affect the lung in a multitude of ways, including pleuritis, pleural effusion, pulmonary fibrosis, Caplan syndrome and vasculitis. We will focus on pulmonary fibrosis in this section.

Pulmonary fibrosis in RA is often asymptomatic. It is most common in seropositive patients, those with high ANA titres, nodules and multisystem disease. If present, symptoms include dyspnoea and cough. Crackles are mostly bibasal.

Management options are steroids and immunosuppressive therapy, however prognosis is poor and these therapies are often not effective.