Sargin Gokhan, Senturk Taskin
Department of Rheumatology, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
Reumatologia. 2015;53(5):276-8. doi: 10.5114/reum.2015.55831. Epub 2015 Dec 8.
We present a case of 45-year-old female patient with the diagnosis of seropositive rheumatoid arthritis, who was admitted to our rheumatology department with exacerbation of the disease. The patient's disease activity score (DAS 28) was 6.9. Physical examination revealed changes in the lung auscultation as a rough breathing sound at the middle and lower lobe of the right lung. Chest X-ray revealed multiple nodular densities in both lungs. Lung biopsy was performed for the diagnosis and revealed necrotizing granulomas with central fibrinoid necrosis surrounded by epithelioid cells. Such a histopathological picture is typical for rheumatoid nodules. Finally the patient was treated with rituximab, with significant improvement.
我们报告一例45岁血清阳性类风湿关节炎女性患者，因病情加重入住我院风湿科。患者的疾病活动评分（DAS 28）为6.9。体格检查发现肺部听诊有变化，右肺中、下叶呼吸音粗糙。胸部X线显示双肺多发结节状密度影。为明确诊断进行了肺活检，结果显示坏死性肉芽肿，中央为纤维蛋白样坏死，周围是上皮样细胞。这种组织病理学表现是类风湿结节的典型表现。最后患者接受了利妥昔单抗治疗，病情显著改善。
