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RA Lung

April 13, 2013

Mary  JoI had my chest CT Scan yesterday.  I put on a patient gown.  An IV was started after the tech asked me a series of questions.  The machine is like the ones in the movies. When the dye was injected, I could feel it in my groin although the IV was in my arm.  There was a strange feeling associated with it.  Most simply:  I felt a loss of control.  My concern was in passing out.  I didn’t. I felt a little light headed after but was able to drive back to work.

I have researched lung involvement in RA.  I was amazed.  The Mayo Clinic did an impressive study with surprising results.  They found that 50% of those with RA had lung issues. They found that 25% of those with RA had RA lung. RA lung is specific to the disease. It involves the same autoimmune response of inflammation and damage which usually means involving fibrosis.  The lung may be involved in several ways.

Nodules may form in the lung. These are usually benign and often go unnoticed.

The pleura may be involved. The pleura are the membranes that cover the lungs. Inflammation may make it hard to breathe. A dry cough my be present. As the pleura thickens due to inflammation, the lungs have a harder time doing their work.

There may also be airway involvement. Briefly, even the larynx can be involved in RA.

COPD, chronic obstructive pulmonary disease, is higher in RA unrelated to smoking.

10% of those with RA develop interstitial lung disease. This affects the interstitium, adjacent air spaces, peripheral airways and blood vessels.  The inflammation eventually causes fibrosis and essentially destroys the lung tissue. There is no specific treatment at present. I have read that one of the benefits  of early diagnosis is being able to get on the lung transplant list early. Prognosis is 2.6 years. Hopefully, this is not the results they find on my scan.

Apparently there is a thing called drug induced lung disease. I am on methotrexate.  It can cause ILD, interstitial lung disease.  Again methotrexate works for me so I hope this is not the case for me.

My labs came back. I was happy to see my inflammation markers in the normal range. I don’t feel that I am on that downward slope that I was worrying about.

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