Lung involvement in rheumatoid arthritis: what do we know?

Rheumatoid arthritis (RA) is a chronic, multisystemic inflammatory disorder that predominantly affects joints but also presents significant extra-articular manifestations, with a particular emphasis on pulmonary involvement. This review elucidates the spectrum of pulmonary complications in RA, focusing primarily on interstitial lung disease (ILD), and analyzes the efficacy of different treatment modalities. Our comprehensive review includes various studies and reports evaluating the clinical presentations, diagnostic approaches, and treatment outcomes of patients with RA-related pulmonary diseases. We paid particular attention to radiological findings, particularly high-resolution computed tomography (HRCT), and assessed the impact of different pharmacological treatments. The findings revealed that pulmonary involvement in RA varies, ranging from asymptomatic patients to patients with severe ILD. Interstitial pneumonia has emerged as the most prevalent manifestation, affecting up to 60% of patients and, in some cases, preceding joint symptoms. The effectiveness of treatments varies, with specific disease-modifying antirheumatic drugs (DMARDs) showing potential for controlling pulmonary symptoms. However, the risk of medication-induced pulmonary toxicity is a notable concern. Early diagnosis and tailored treatment strategies are crucial for the effective management of RA-related pulmonary diseases.