Krecipro-Nizińska Ewa, Morgiel Ewa, Smiechowicz Helena, Wiland Piotr
Klinika Reumatologii i Chorób Wewnetrznych Akademii Medycznej we Wrocławiu ul. Borowska 213, 50-556 Wrocław.
Ann Acad Med Stetin. 2010;56 Suppl 1:86-90.
Rheumatoid arthritis is a systemic inflammatory disease characterized by destructive synovitis and systemic extra-articular involvement exemplified by rheumatoid nodules occurring in the skin, lungs, and other parenchymatous organs. Antirheumatic drugs like methotrexate and leflunomide are known to predispose to the development of pulmonary rheumatoid nodules. We report the case of a 60-year-old male with rheumatoid arthritis previously treated with methotrexate and cyclosporin, in whom multiple pulmonary nodules were disclosed. The patient was extensively diagnosed to exclude any malignancy. Pulmonary rheumatoid nodules were recognized, methotrexate was withdrawn, and cyclophosphamide pulses were started. The size of the nodules decreased and the patient was started on cyclosporin.
类风湿性关节炎是一种全身性炎症性疾病，其特征为破坏性滑膜炎和全身性关节外受累，如皮肤、肺及其他实质器官出现类风湿结节。已知抗风湿药物如甲氨蝶呤和来氟米特易引发肺部类风湿结节。我们报告一例60岁男性类风湿性关节炎患者，此前接受过甲氨蝶呤和环孢素治疗，发现其有多个肺结节。对该患者进行了全面诊断以排除任何恶性肿瘤。确诊为肺部类风湿结节后，停用甲氨蝶呤，并开始给予环磷酰胺冲击治疗。结节大小缩小，随后患者开始使用环孢素。
