How Arthritis Affects the Lungs

Rheumatoid arthritis is an autoimmune disease that primarily manifests itself as painful, stiff joints. But because it's a systemic illness, it can affect other parts of the body. The lungs are one area where problems often surface. In fact, people can sometimes find themselves suffering from lung problems before they're even aware of any joint issues. Some of the more typical issues you may face if you have rheumatoid arthritis include:

  • Pain upon inhaling. Pleurisy, or inflammation of the lining of the lungs, can result from rheumatoid arthritis. If you experience sharp pain when you inhale, you may have pleurisy.
  • Difficulty catching your breath. If fluid accumulates in the lungs due to pleurisy, it can cause shortness of breath. But shortness of breath, accompanied by wheezing, excessive mucus, chronic cough, and recurrent colds and lung infections, may also signal a serious condition known as chronic obstructive pulmonary disease (COPD). A recent Israeli study of more than 31,000 patients found that people with rheumatoid arthritis are twice as likely as others to have COPD, even after accounting for such risk factors as smoking, obesity, and socioeconomic status.
  • Dry cough, fatigue, loss of appetite. Any or all of these symptoms can signal scarring of the lungs, a potential complication of the disease.
  • Lung nodules. Unlike many other lung-related arthritis problems, nodules on the lung rarely make themselves known. You can't feel them, and they don't normally pose any particular hazards. They can, however, rupture, leading to collapsed lungs.

Should you treat arthritis-related lung problems? It depends on what you're experiencing. Consult with your rheumatologist. He may prefer to target the rheumatoid arthritis itself in the hopes that your lung issues will clear up as a result. Or you may need specific procedures such as fluid removal from the lungs.

Rheumatoid arthritis patients should be aware that methotrexate, one of several drugs commonly used to treat the disease, can itself cause lung problems at times. So-called "methotrexate pneumonitis" (inflammation) occurs in anywhere from less than one percent to almost seven percent of patients taking the drug, with the first year on methotrexate presenting the greatest risk. Smokers and those with underlying lung disease are at higher risk of developing this complication.



Saravanan V and Kelly C (2006). Drug-Related Pulmonary Problems in Patients With Rheumatoid Arthritis. Rheumatology, 45(7), 787-789; Mayo Clinic,; European League Against Rheumatism,