Acute lung involvement in RA is not always ILD

Rheumatoid arthritis is a systemic inflammatory disorder with diverse extra-articular manifestations including vasculitis, lung disease, inflammatory eye disease and subcutaneous nodule formation. Among these manifestations, lung disease has been identified as a primary contributor of morbidity and mortality. The predominance of non-specific interstitial pneumonia pattern has been observed in most forms of connective tissue-associated ILD. Studies have demonstrated that the usual interstitial pneumonia (UIP) pattern is more prevalent among patients with RA-associated ILD. The extra-articular manifestations have been noted in nearly 50% of the patients, and the lung involvement in majority of the cases.8, 9 This study details the occurrence of lung involvement of viral etiology in RA, which could be misdiagnosed as RA-associated ILD.