Kase C, Okubo M, Yamasaki M, Yamada H, Suzuki Y, Hama N, Ichikawa Y, Sasaka K, Nakajima Y
Department of Internal Medicine & Radiology, Saint Marianna University School of Medicine, Kawasaki-city, Kanagawa.
Ryumachi. 2001 Aug;41(4):745-50.
We discribe a rare case of rheumatoid arthritis (RA) complicated with bronchiolitis obliterans that was successfully treated with minocycline. Sixty four-year old woman with a four-years history of RA was admitted to the hospital because of dyspnea on exertion and polyarthritis. Pulmonary function test revealed marked decrease in V25 (0.10 l/s: 6.9%) and MMFR (12.6%). High resolution CT of the lung showed scattered centri-lobular micronodules in both lung fields, mucoid impaction, and hyperinflation. These findings indicated the presence of bronchiolitis obliterans. After 3 months of the treatment with minocycline, the patient showed a significant improvement of both arthritis and pulmonary function. Chest CT findings also improved after 1 year. The present case suggests that minocycline is effective for the treatment of bronchiolitis obliterans seen in patients with RA.
我们描述了一例罕见的类风湿关节炎（RA）合并闭塞性细支气管炎的病例，该病例用米诺环素成功治愈。一名64岁有4年RA病史的女性因劳力性呼吸困难和多关节炎入院。肺功能测试显示V25（0.10升/秒：6.9%）和最大呼气中期流速（MMFR，12.6%）显著下降。肺部高分辨率CT显示双肺野散在的小叶中心性微小结节、黏液嵌塞和肺过度充气。这些发现提示存在闭塞性细支气管炎。在用米诺环素治疗3个月后，患者的关节炎和肺功能均有显著改善。胸部CT检查结果在1年后也有所改善。本病例提示米诺环素对治疗RA患者出现的闭塞性细支气管炎有效。
