In addition to damaging joints, rheumatoid arthritis can also affect your lungs. The most serious disease is interstitial lung disease, which can be tough to detect.

Despite its name, rheumatoid arthritis doesn't just affect your joints. It can also damage the tissue surrounding the joints, as well as your eyes, heart, and lungs.

“We call it rheumatoid arthritis, but we should really call it rheumatoid disease,” says Elinor Mody, MD, director of the Brigham and Women’s Hospital Women’s Orthopedic and Joint Disease Center in Boston.

Rheumatoid arthritis can damage the whole body. Besides the joints, the “heart and lungs are the most commonly affected,” Mody says. Doctors aren’t sure how or why rheumatoid arthritis causes other organs to suffer, but lung complications of rheumatoid arthritis can be serious and even cause death.

Rheumatoid Arthritis: Interstitial Lung Disease

Rheumatoid arthritis-associated interstitial lung disease, or RA-ILD, is the most serious lung complication for people with rheumatoid arthritis. This illness can be hard to detect, but occurs when lung tissue becomes inflamed and eventually scarred. Here’s what we do know:

• Risk factors. Men are at higher risk than women for this disease. Although non-smokers can and do develop RA-ILD, smoking seems to increase risk.
• Symptoms. RA-ILD may cause breathlessness and dry cough, but in many cases it causes no symptoms at all, making early detection difficult.
• Treatment. More research is still needed to find effective treatment. “This is a difficult disease to treat,” Mody says. “There is a trial now going on with rituximab (Rituxan) for the treatment of rheumatoid arthritis lung disease, but nothing has been very successful to date.”

Rheumatoid Arthritis: Pulmonary Fibrosis

Inflammation, like the kind caused by RA-ILD, can lead to pulmonary fibrosis, or permanent scarring of the respiratory tissues. This can cause shortness of breath, since healthy air sacs are replaced by scar tissue. Supplemental oxygen can help make breathing easier, but will not reverse the damage done by pulmonary fibrosis.

Unfortunately, methotrexate (Trexall), a medication often used to treat rheumatoid arthritis, can cause pulmonary fibrosis. If you take this drug, your doctor should monitor your respiratory status especially closely.

Rheumatoid Arthritis: Nodules

Rheumatoid arthritis can also cause nodules to form in the throat and on the vocal cords, causing complications like hoarseness and other changes. Nodules can develop in the lungs as well, but usually don’t cause symptoms and patients may never notice them.

Rheumatoid Arthritis: Other Lung Complications

According to the Johns Hopkins Arthritis Center, damage to the lining of the lung, or the pleura, affects more than half of all people with rheumatoid arthritis, but few actually experience symptoms. Problems include:

• Pleurisy, or inflammation of the pleural tissue, causes chest discomfort and difficulty breathing.
• Effusions, fluid that builds up in the pleural space around the lungs, can lead to a persistent cough, shortness of breath, and a collapsed lung.

Rheumatoid Arthritis: Prevention of Respiratory Issues

Because of the high risk of complications due to rheumatoid arthritis-associated lung disease, prevention is key. To help reduce your risk:

• Don't smoke. If you do, ask your doctor for suggestions about how to quit smoking immediately. Chemicals found in cigarettes can irritate already delicate lung tissue, leading to further complications.
• Have regular checkups. Your doctor should listen to your lungs and monitor your breathing at each visit. Lung problems that are detected early can be easier to treat.

If you have rheumatoid arthritis and are experiencing shortness of breath, coughing, or other respiratory symptoms, talk to your doctor. These are potentially serious symptoms that merit fast attention.