Rheumatoid Lung Disease

Abstract

A review of 700 patients with rheumatoid arthritis revealed 8 instances of moderate or severe diffuse pulmonary fibrosis. The course of the pulmonary disease was variable but characterized by dyspnea on exertion, the frequent occurrence of subcutaneous nodules, clubbing of the fingers, and in 3 instances cor pulmonale with death. There was no correlation between the severity of arthritis and the severity of the lung disease. Histologic examination of the lung in 1 patient revealed a progression from diffuse interstitial pneumonitis to diffuse pulmonary fibrosis over a period of 5 years. It was concluded that the lung tissue in patients with rheumatoid disease is exceptionally reactive and that much of the pathology in the lung may be accounted for by an exceptional tissue response to ordinary pathogenic stimuli.