Pulmonary fibrosis, often called “scouring pad lung” due to the stiff, scarred texture it creates in the lungs, can severely impact quality of life—and even become life-threatening. Alarmingly, many individuals living with rheumatoid arthritis (RA) remain unaware of the strong link between their condition and lung health, often discovering the issue only after significant and irreversible lung damage has occurred.
According to Dr. Tsao Yen-Po, a specialist in Allergy, Immunology, and Rheumatology at Taipei Veterans General Hospital, RA doesn’t just affect joints—it can also invade the lungs. Research shows that around 30 to 40 percent of RA patients may develop pulmonary fibrosis. If left untreated, this condition can progress into progressive pulmonary fibrosis (PPF), a serious form with a five-year survival rate lower than many cancers. That’s why early lung function screening and timely intervention are critical.
Don’t Ignore Fatigue, Cough, or Breathlessness—Lung Function Tests Are Key
When an RA patient’s immune system becomes overactive, it may damage the lung tissue, leading to scarring, reduced elasticity, and impaired gas exchange. Common symptoms include fatigue, chronic cough, and shortness of breath—often mistaken for aging or other respiratory issues. Dr. Tsao stresses that because these signs can be subtle or confusing, RA patients should consult their physician about scheduling an initial lung function test. Follow-up tests can then be planned based on the findings, offering a better chance of detecting abnormalities early.
Dr. Tsao adds that lung capacity reduction isn’t always noticeable in daily life, which makes diagnostic tools essential. Lung function tests not only help determine the extent of fibrosis but also track disease progression. If abnormalities are detected, doctors may follow up with a high-resolution CT scan to assess the extent of lung damage. These tests are also necessary for applying for government-covered anti-fibrotic medications.
He emphasizes that every RA patient should have at least one baseline lung function record and be honest with their doctor during follow-ups about any physical changes or discomfort, so medical teams can properly monitor and manage the condition.
Other High-Risk Groups Should Be Alert Too
While pulmonary fibrosis is irreversible, it can be slowed with anti-fibrotic medications, which help preserve lung function and improve overall quality of life. Dr. Tsao reminds us that other autoimmune diseases—such as Sjögren’s syndrome, scleroderma, dermatomyositis, polymyositis, and lupus—are also linked to pulmonary fibrosis. Patients with these conditions should communicate openly with their rheumatologist or pulmonologist about any lung symptoms.
Additionally, people over 55, long-term smokers, those with gastroesophageal reflux disease (GERD), or individuals regularly exposed to hazardous substances at work or in their environment are also at higher risk. Persistent symptoms such as fatigue, cough, or breathlessness lasting more than eight weeks warrant a visit to a pulmonologist.
Three At-Home Lung Health Self-Checks
To help the public assess their own lung health, Dr. Tsao shared three simple self-check tips on a recent program:
- Climb three flights of stairs – Do you feel out of breath?
- Count your breaths – Measure your breathing rate in one minute.
- Try a long exhale – Is it difficult to breathe out slowly and fully?
These quick checks can give you early clues about your lung function—and serve as a prompt to seek medical advice if anything feels off. Early action can make all the difference.
