Rheumatoid arthritis and pleural effusion: A clinical case and literature review

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects approximately 1% of the world's population, being more prevalent in women and with a peak incidence between 40 and 60 years of age. RA is characterized by synovial inflammation that leads to progressive destruction of the joints, resulting in pain, deformity, and functional loss. In addition to joint manifestations, RA can present with several extra-articular manifestations, such as rheumatoid nodules, vasculitis, and pulmonary involvement. (1, 2)

Pulmonary involvement in RA is a significant complication, occurring in up to 20% of patients, and can include conditions such as pulmonary fibrosis, bronchiolitis obliterans, and pleuritis. Pleural effusion, although less common, is a potentially severe manifestation that can occur in patients with RA, and is often underdiagnosed. Studies show that pleural effusions are present in about 5% of RA patients, and may be the first sign of lung involvement in the disease. (3)

The objective of this study is to report the case of a middle-aged patient who was unaware of the diagnosis of RA and presented dyspnea as a guiding symptom at admission. The patient was diagnosed with pleural and pericardial effusion, and a retrospective investigation revealed the presence of persistent joint pain. The report seeks to highlight the clinical reasoning involved in the investigation of pleural effusion and to review this rare complication of RA. (4)