Matsui S, Yamashita N, Narukawa M, Hayashi R, Yoshida Y, Arai N, Maruyama M, Kobayashi M, Kitagawa M
First Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Faculty of Medicine, Japan.
Nihon Kokyuki Gakkai Zasshi. 2000 Mar;38(3):195-200.
A 52-year-old man with a 4-year history of rheumatoid arthritis, and who had an episode of suspected BOOP in early 1994, was admitted to our hospital because of cough and fever. A chest X-ray film on admission showed small patchy infiltrates, and a computed tomographic (CT) scan showed centrilobular nodules and patchy infiltrates with thickened broncho-vascular bundles in both lungs. Transbronchial and thoracoscopic lung biopsies disclosed the coexistence of interstitial pneumonia with BOOP pattern, follicular bronchiolitis, and diffuse panbronchiolitis-like purulent and obliterative bronchiolitis. Due to findings of chronic sinusitis, the patient was treated with erythromycin for 8 weeks, and the abnormal CT shadows regressed. This was an interesting case of various pulmonary lesions associated with rheumatoid arthritis, and successfully treated with erythromycin.
一名52岁男性，有4年类风湿关节炎病史，1994年初曾有一次疑似闭塞性细支气管炎伴机化性肺炎（BOOP）发作，因咳嗽和发热入院。入院时胸部X线片显示小片状浸润影，计算机断层扫描（CT）显示两肺小叶中心性结节及片状浸润影伴支气管血管束增粗。经支气管肺活检和胸腔镜肺活检发现存在BOOP型间质性肺炎、滤泡性细支气管炎以及弥漫性泛细支气管炎样化脓性和闭塞性细支气管炎。由于发现有慢性鼻窦炎，该患者接受了8周的红霉素治疗，CT异常阴影消退。这是一例与类风湿关节炎相关的多种肺部病变的有趣病例，并成功用红霉素治疗。
