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Interstitial lung disease in rheumatoid arthritis

Fiona R Lake, MD, FRACP
Section Editors
Talmadge E King, Jr, MD
Eric L Matteson, MD, MPH
Deputy Editor
Helen Hollingsworth, MD


Interstitial lung disease (ILD) is the most common manifestation of rheumatoid lung disease [1-3]. However, rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is not a single type of ILD, but rather is composed of a spectrum of histologic types with different associated patterns of clinical presentation, radiographic features, response to treatment, and clinical course.

Interstitial lung disease complicating rheumatoid arthritis will be reviewed here. Other pulmonary complications associated with rheumatoid arthritis and their management are discussed separately (table 1 and table 2). (See "Overview of lung disease associated with rheumatoid arthritis" and "Drug-induced lung disease in rheumatoid arthritis".)


A spectrum of lung histopathology is seen in rheumatoid arthritis-associated interstitial lung disease (RA-ILD), and the histopathologic types of RA-ILD can generally be categorized according to the American Thoracic Society/European Respiratory Society's classification system for idiopathic interstitial pneumonia (IIP) (table 3). The most common histopathologic types are usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia [4-14]. (See "Idiopathic interstitial pneumonias: Clinical manifestations and pathology".)

Histopathologic patterns of ILD associated with RA include the following [4-13,15]:

Nonspecific interstitial pneumonia (picture 1 and picture 2) (see "Treatment and prognosis of nonspecific interstitial pneumonia")

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Literature review current through: Nov 2017. | This topic last updated: May 11, 2017.
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