[Lung involvements of RA, diagnosis and treatment].
Various pleuro-pulmonary abnormalities and conditions are known to complicate rheumatoid arthritis. Some of them are asymptomatic, tend to ameliorate spontaneously(ex. pleuritis and rheumatoid nodule), others may cause serious conditions and often fatal(ex. interstitial pneumonia and constrictive bronchiolitis). Furthermore therapy-related lung complications and opportunistic infections may develop in RA patients. Clinicians must differentiate these conditions, using serological, physiologic, bacteriological, radiographic, and if necessary, invasive techniques including bronchoscopy and video-assisted thoracoscopic surgery. Therapy may vary according to the nature of these conditions. Appropriate anti-microbial agent must be given for infectious diseases. On the other hands immuno-suppressive therapy should be applied for interstitial pneumonia if the disease progress rapidly and threaten life. Anti-RA drugs should be withdrawn in case of drug-induced lung injury.
Tokuda
Hitoshi
H
Department of Medicine, Social Health Insurance Medical Center.
D018501:Antirheumatic Agents / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001989:Bronchiolitis Obliterans / Q000209:etiology; D018549:Cryptogenic Organizing Pneumonia / Q000209:etiology; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D008727:Methotrexate / Q000009:adverse effects; D010995:Pleural Diseases / Q000209:etiology; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000209:etiology; D012215:Rheumatic Nodule / Q000209:etiology
D018501:Antirheumatic Agents; D008727:Methotrexate