[Cardiac and pulmonary manifestations in rheumatoid arthritis]

Pericarditis may be the most common cardiac manifestation in RA patients and the incidence in autopsy cases is more than 30%. Pericardial effusion shows low sugar and complement level and high level of LDH and gamma-globulin. The administration of corticosteroids has been successfully used in the treatment of rheumatoid pericarditis. The pulmonary involvement in RA include pleuritis, nodules and interstitial lung disease. Interstitial lung disease in RA patients appears to run a continuum from mild pneumonitis to severe pulmonary fibrosis and occasionally it include bronchiolitis obliterans organizing pneumonia (BOOP) which is sensitive to corticosteroid therapy. Although open lung biopsy is the definitive procedure for proving the diagnosis of interstitial lung disease, open lung is now being complemented or replaced by transbronchial lung biopsy and bronchoalveolar lavage (BAL). Corticosteroids will be effective to BOOP definitely and in general usual interstitial pneumonia (UIP) is resistant to treatment. In addition to the primary pulmonary manifestations of RA, anti-rheumatic drug reactions in the lung may be associated.