A man has a follow-up appointment with his rheumatologist after receiving a diagnosis of rheumatoid arthritis (RA) five years earlier. Fortunately, he takes medicine to effectively manage his arthritis. He is pain-free while walking and going about his everyday business. However, he has been experiencing dyspnoea when stair climbing for the last six months. He also has a bothersome dry cough. COVID-19? That is immediately ruled out. However, an early fibrosis (scarring) of the lungs on a CT scan of his chest indicates that he most likely has rheumatoid arthritis. The irate patient exclaims, “I can finally walk normally, and now I can’t breathe when I walk!” A pulmonologist’s thorough examination is the following step.
What is autoimmune lung disease?
This man’s story provides an illustration of a rare but possibly fatal consequence linked to autoimmune or rheumatic disorders, such as:
- rheumatoid arthritis, an inflammatory condition affecting the joints mainly
- Scleroderma, also known as systemic sclerosis, is a fibrosing illness that usually affects the skin.
- Dermatomyositis causes inflammation in the skin and muscles.
- systemic lupus erythematosus, sometimes known as lupus, is an inflammatory disease that can impact the skin, kidneys, joints, and other body components.
This consequence is known by several names, including interstitial lung disease, autoimmune lung disease, and interstitial fibrosis. It is one of many possible consequences affecting many organs in individuals with an underlying autoimmune or rheumatic disease. It is characterised by lung inflammation and/or scarring.
What is autoimmunity?
Normally, our immune system protects against cancer and prevents infection. The phrase “autoimmunity” suggests that an individual’s immune system may occasionally view its own biological tissue as alien. The body responds to this by mounting an immunological attack against itself. Rheumatoid arthritis typically affects the joints of those who have it. However, 10% of people will also experience symptoms of lung disease similar to the patient mentioned earlier.
Why is it critical to diagnose autoimmune lung disease at the earliest opportunity?
According to studies, among those with autoimmune disorders, this complication is one of the main causes of illness and mortality. Treatments that target inflammation in the early stages of a disease sometimes show positive results (corticosteroids, for example). However, patients primarily suffering from fibrotic illness may be more challenging to treat and have worse results, such as incapacity or an oxygen requirement — and in rare circumstances, even a lung transplant. But the rate at which this complication advances differs. While some people see little to no progression, others may find that it advances faster. Because of this, close observation by a pulmonologist who can track lung function at routine examinations is crucial.
Who is most at risk and what causes this complication?
Population studies have revealed risk profiles, even if conclusive research has not yet been conducted. The chance of developing autoimmune lung disease is increased in males, those with a history of cigarette smoking, and those with certain antibodies and genetic markers. Air pollution, occupational exposure, and environmental variables may also contribute to the development of lung-related autoimmunity (see here and here). A silent aspiration into the lungs due to oesophageal dysfunction, a common symptom in many autoimmune illnesses, or drugs that may induce lung harm are other possible causes.
Is it possible to treat autoimmune lung disease?
Yes, however, there are differences in efficacy. Anti-inflammatory drugs, such as corticosteroids, frequently assist when inflammatory disease is detected early enough to prevent significant scarring from developing. Additionally, a better prognosis is typically achieved by identifying and treating inflammation early on.
The FDA in the US has approved nintedanib (Ofev) and pirfenidone (Esbriet) to treat idiopathic pulmonary fibrosis (IPF), a distinct kind of fibrotic lung disease. Patients with autoimmune lung diseases can now utilise nitedanib. Both medications appear to be able to slow down lung fibrosis but not seem to be able to reverse it. More extensive research is required to determine whether these medicines improve quality of life and have significant positive effects on sickness and mortality.
What steps can I take to maintain my best health if I have an autoimmune or rheumatoid arthritis?
The most crucial initial action is to remove any recognised dangers that could contribute to or worsen lung illness. If you need to, work with your doctor to quit smoking. See if you can stop taking any drugs or being exposed at work that could aggravate your lung problems. Rheumatologists frequently use pulmonary function testing and CT scanning to screen patients for lung disease at the time of diagnosis if they are thought to be at higher risk, as the goal is early detection of lung inflammation. Rheumatologists are increasingly adopting rigorous surveillance over an extended period of time as standard procedure.
Speak with your doctor if you experience any symptoms, such as shortness of breath and a dry cough, that point to an autoimmune lung disease. The next course of action could involve a referral to a pulmonologist or to a multidisciplinary centre where pathologists, radiologists, rheumatologists, and pulmonologists collaborate to diagnose complications like these and create treatment plans that stop or reduce the progression of lung illness.
Regular health checks at Echelon Health
In terms of managing personal healthcare, private health checkups are a major advancement. They provide a comprehensive, individualised approach that surpasses the scope of typical health evaluations. Choosing to have a private health checkup is a proactive move that people take to ensure a healthy future, in addition to investing in their current well-being.
In the modern world, where proactive health management can result in long-term health advantages and a higher quality of life, this all-encompassing approach to health is vital. Private health checks are expected to become a crucial component of health management for people who value their health and well-being as a result of advances in medical technology and an increasing emphasis on preventative healthcare.
This is why Echelon Health has created the Platinum Health Assessment.
This is a full-body health check that leaves no stone unturned and works on a case-by-case basis in order to provide results that are personal to you and your circumstances. Combining over 30 years of medical expertise and the use of the most advanced imaging technology available in the world today (through CT, MRI, and ultrasound scanners), along with fully comprehensive blood tests looking at over 40 parameters, including cancer markers, hormones, and more, we can confidently say that we can detect up to 92% and 95% of preventive causes of death among men and women.
Here are the scans included in the Platinum Assessment:
- Blood Tests
- ECG
- CT Aorta
- CT Heart
- CT Coronary Angiogram
- CT Chest
- CT Pelvis
- CT Virtual Colonoscopy
- CT Bone Density
- EOS
- CT Upright Skeleton
- MRI Brain
- MRI Cerebral Artery Angiogram
- MRI Carotid Artery Angiogram
- MRI Prostate
- Ultrasound Thyroid
- Ultrasound Testes/Ovaries
- Digital Mammogram
- Full-body Mole Screen
If you have any questions about our services or how we can help you achieve optimal health, please don’t hesitate to contact us. Our team is always happy to assist you!
