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Rheumatoid Arthritis and the Lungs

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Orphan Lung Diseases

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Abstract

Rheumatoid arthritis (RA) is a common autoimmune disease affecting approximately 0.5% of the global population. All compartments of the respiratory system can be involved with interstitial lung disease (ILD), airways disease (AD) and pleural disease being the most common. The reported prevalence of ILD ranges from 19% to 67% and risk factors include smoking, male sex, advanced age, and RA disease activity. Though it can be subclinical, a subset of patients will have progressive fibrosis and death. There are no medications approved specifically for RA-ILD. AD is seen in up to 44% of patients and subtypes include constrictive/obliterative bronchiolitis (OB), follicular bronchiolitis, bronchiectasis, asthma, and COPD. OB traditionally was associated with a poor prognosis though recent studies show better outcomes. Bronchiectasis is often an incidental finding on chest imaging and may be related to recurrent infections. The incidence of asthma and COPD is higher in patients even after controlling for smoking. Pleural disease, including pleuritis and pleural effusion, is common in RA and often asymptomatic.

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Authors and Affiliations

  1. Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA

    Joshua J. Solomon

  2. National Jewish Health, Denver, CO, USA

    Kevin Brown

  3. Rheumatology, University of Colorado, Denver, CO, USA

    Mary Kristen Demoruelle

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  1. Joshua J. Solomon
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  2. Kevin Brown
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Editors and Affiliations

  1. Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases (OrphaLung), Louis Pradel Hospital, University of Lyon, Lyon, France

    Vincent Cottin

  2. Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy

    Luca Richeldi

  3. National Jewish Health, Denver, CO, USA

    Kevin Brown

  4. Division of Pulmonary, Critical Care, and Sleep Medicine Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA

    Francis X. McCormack

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Solomon, J.J., Brown, K., Demoruelle, M.K. (2023). Rheumatoid Arthritis and the Lungs. In: Cottin, V., Richeldi, L., Brown, K., McCormack, F.X. (eds) Orphan Lung Diseases. Springer, Cham. https://doi.org/10.1007/978-3-031-12950-6_13

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