Document Detail

A simultaneous onset of organizing pneumonia and rheumatoid arthritis, along with a review of the literature.
MedLine Citation:
PMID:  18159567     Owner:  NLM     Status:  MEDLINE    
Organizing pneumonia (OP) is a specific type of interstitial pneumonia that has been noted as one of the pulmonary manifestations during the course of rheumatoid arthritis (RA). In this study, we report a case with a simultaneous development of OP and RA. The patient presented with concurrent flu-like symptoms and arthralgia of multiple joints, and antibiotic therapy was not effective. The rheumatoid factor (RF) and anti-cyclic citrullinated antibodies were both high. Multiple air-space opacities on chest radiographs and bilateral peripheral consolidations on high-resolution computed tomography films were evident. The histology of transbronchial lung biopsy samples was characterized by intra-alveolar buds of granulation tissue consisting of intermixed myofibroblasts and connective tissues. Treatment with prednisolone induced a complete recovery from OP without relapses. Our review of previous reports about RA-associated OP (RA-OP) suggested that the high titer of RF and increased disease activity of RA indicate a great risk of developing OP. This condition may represent a lung's reaction in the RA-associated inflammatory and/or immune process. We should be aware of RA-OP cases in which pulmonary manifestations precede articular symptoms. In these cases, respiratory manifestations are the main evidence of RA activity. In most cases of steroid-resistant RA-OP, the use of immunosuppressants was effective. Since OP may progress to fibrotic lung disease during the course of RA, we may consider performing a second lung biopsy for steroid-resistant patients, even if they have once been diagnosed as OP.
Shunsuke Mori; Isamu Cho; Yukinori Koga; Mineharu Sugimoto
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2007-12-26
Journal Detail:
Title:  Modern rheumatology / the Japan Rheumatism Association     Volume:  18     ISSN:  1439-7595     ISO Abbreviation:  Mod Rheumatol     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-05     Completed Date:  2008-05-20     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100959226     Medline TA:  Mod Rheumatol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  60-6     Citation Subset:  IM    
Clinical Research Center for Rheumatic Disease and Department of Rheumatology, Kumamoto Saishunsou National Hospital, Kumamoto, Japan.
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MeSH Terms
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / complications*,  diagnosis*,  drug therapy
Colonography, Computed Tomographic
Cryptogenic Organizing Pneumonia / complications*,  drug therapy,  pathology
Middle Aged
Rheumatoid Factor / blood*
Reg. No./Substance:
0/Antirheumatic Agents; 9009-79-4/Rheumatoid Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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