From koreabiomed.com
Some pulmonary fibrosis, the progressive hardening of the lungs that causes breathing difficulties, occurs in relation to rheumatoid arthritis (RA). Specific patient groups are at a higher risk of RA-related pulmonary fibrosis, which affects 3-15 percent of all RA patients.“Rheumatoid arthritis mostly affects middle-aged women. However, suppose RA occurs in men or older adults. In that case, there are problems (due to higher chances of rheumatoid arthritis-related pulmonary fibrosis,” said Professor Kim Hyun-sook of the Department of Rheumatology at Soon Chun Hyang University Hospital Seoul on the Korean Blood Disease and Cancer Association's YouTube channel, “KBDCA.”
It's unclear why pulmonary fibrosis occurs in around 10 percent of patients with RA, an autoimmune disease. However, it is believed that some autoantibodies that attack the joints also attack the bronchi and alveoli of the lungs, causing inflammation and fibrosis.
In addition to being male and older, there are other characteristics of patients at high risk for RA-related pulmonary fibrosis.
“We test patients with rheumatoid arthritis for rheumatoid factor or anti-CCP (anti-cyclic citrullinated peptide) antibodies, and those with exceptionally high levels of the factor have a high risk of RA-related pulmonary fibrosis,” Professor Kim said. “Anti-CCP antibodies are normal at 5 to 15, but many patients with high levels are more likely to be hit at their lungs.”
Specific gene variants are also associated with the development of RA-related pulmonary fibrosis.
“We've looked at some genetic variants and found that certain genetic variants are associated with an increased risk of pulmonary fibrosis, so it may be important to get screened if you have a family history of the disease,” said Professor Yoon Hee-young of the Department of Respiratory and Allergy Medicine at the same hospital.
People with poorly controlled rheumatoid arthritis are also at higher risk for RA-related pulmonary fibrosis. Besides, there are other cases where the risk of pulmonary fibrosis is increased in people with rheumatoid arthritis regardless of the disease.
“Some patients may develop or worsen pulmonary fibrosis, not necessarily because of RA, but because they are taking medications that can affect the lungs (respiratory toxicants),” Professor Kim said. “Screening, diagnosis, and treatment should be tailored to each individual's risk.”
If diagnosed with RA-related pulmonary fibrosis, there is one thing that all patients should do -- stop smoking.
“Another important risk factor (for RA-related pulmonary fibrosis) is smoking,” Professor Yoon said. “Certainly, it has been reported that patients who smoke have a higher incidence of pulmonary fibrosis. We explain to patients that they should quit smoking if they are diagnosed with pulmonary fibrosis.”
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