Mishima K, Ichikawa Y, Arimori S
Department of Internal Medicine, School of Medicine, Tokai University, Kanagawa.
Ryumachi. 1990 Apr;30(2):126-32.
A forty-eight year-old female with rheumatoid arthritis developed cough, sputum and dyspnea. Chest X-ray film demonstrated bilateral diffuse interstitial pneumonia and pulmonary fibrosis. Laboratory findings were as follows: ESR 29 mm/h, CRP 3.86 mg/dl, RA test (+), RAHA (-) and WBC 7200/mm3. Marked hypoxemia (po(2)45 Torr) was demonstrated by blood gas analysis. Asymptomatic pulmonary fibrotic lesions which preceded articular symptoms were identified on her previous chest X-ray films. Methylprednisolone-pulse therapy (1g/day, for 3 days) was repeated three times with a 2-week interval. The treatment rapidly improved both pulmonary symptoms and chest X-ray findings. Although the fibrotic shadows on chest X-ray did not completely disappear, her conditions have been maintained well under the treatment with prednisolone (10mg/day) plus D-penicillamine (200mg/day).
一名48岁患有类风湿性关节炎的女性出现咳嗽、咳痰和呼吸困难。胸部X光片显示双侧弥漫性间质性肺炎和肺纤维化。实验室检查结果如下：血沉29毫米/小时，C反应蛋白3.86毫克/分升，类风湿因子检测（+），类风湿血凝试验（-），白细胞7200/立方毫米。血气分析显示明显的低氧血症（动脉血氧分压45托）。在她之前的胸部X光片上发现了在关节症状之前出现的无症状肺纤维化病变。甲基强的松龙冲击疗法（1克/天，共3天）每隔2周重复3次。治疗迅速改善了肺部症状和胸部X光检查结果。虽然胸部X光片上的纤维化阴影没有完全消失，但在泼尼松龙（10毫克/天）加青霉胺（200毫克/天）的治疗下，她的病情一直保持良好。
