Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Department of Pulmonary and Critical Care Medicine, University of California, San Francisco, CA 94117, USA.
Chin Med J (Engl). 2023 Feb 5;136(3):280-286. doi: 10.1097/CM9.0000000000002577.
The lungs are one of the most common extra-articular organs involved in rheumatoid arthritis (RA), which is reported to occur in up to 60% to 80% of RA patients. Respiratory complications are the second leading cause of death due to RA. Although there is a wide spectrum of RA-associated respiratory diseases, interstitial lung disease is the most common manifestation and it impacts the prognosis of RA. There has been progress in understanding the management and progression of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and RA-associated respiratory diseases recently, for example, opportunistic pulmonary infectious diseases and toxicity from RA therapies. From a chest physicians' perspective, we will update the diagnosis and treatment of RA-associated ILD, methotrexate-associated lung disease, and the complication of Pneumocystis jiroveci pneumonia in RA in this review.
肺部是类风湿关节炎（RA）累及的最常见关节外器官之一，据报道，高达 60%至 80%的 RA 患者会出现肺部受累。呼吸并发症是导致 RA 患者死亡的第二大原因。尽管 RA 相关的呼吸系统疾病有广泛的表现，但间质性肺疾病是最常见的表现，它会影响 RA 的预后。近年来，人们对类风湿关节炎相关间质性肺疾病（RA-ILD）和 RA 相关呼吸系统疾病的管理和进展有了更深入的了解，例如机会性肺部感染性疾病和 RA 治疗的毒性。从胸科医生的角度来看，我们将在本次综述中更新 RA 相关间质性肺疾病、甲氨蝶呤相关肺疾病以及 RA 中卡氏肺孢子虫肺炎并发症的诊断和治疗。
