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Arthritis and Rheumatism

How Does Rheumatoid Arthritis Cause Pleurisy?

02/20/2008

Question:

My doctor said that the pleurisy I have was caused by my RA. Can you give me some more information about this and how the two are linked?

Answer:

The hallmark pathology of Rheumatoid Arthritis (RA) is joint inflammation. However, RA is a systemic disease and certainly can have associated extra-articular features, one of which is respiratory manifestations. Inflammation of the lung lining is called pleuritis which may lead to pain with deep inspiration, commonly referred to as pleurisy. Symptoms of pleurisy, if related to the underlying RA, do not necessarily demand treatment as the episodes may be episodic and resolve without treatment. Occasionally, fluid within the lung lining (pleural effusion) may be found in individuals with RA. Sometimes these fluid collections do not produce any symptoms and are found incidentally on a chest x-ray. Treatment for pleuritis or pleural effusions may be required if they produce chronic symptoms or if they cause respiratory compromise such as shortness of breath.

Final thought: Pleurisy and pleural effusions may affect any individual with RA, even if they have a normal rheumatoid factor blood test. Rheumatoid nodules and lung fibrosis are much less likely to occur in the setting of a normal rheumatoid factor.

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University