Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.
Department of Pathology, Saitama Cardiovascular and Respiratory Center, Japan.
Intern Med. 2021 Dec 1;60(23):3779-3783. doi: 10.2169/internalmedicine.6915-20. Epub 2021 Jun 19.
A 58-year-old woman with rheumatoid arthritis (RA) visited our hospital complaining of a persistent cough and sputum for the past year. She had a high cold hemagglutinin titer and chronic sinusitis. Chest computed tomography revealed bilateral diffuse centrilobular nodules, bronchiectasis, and bronchial wall thickening. A surgical lung biopsy was performed that confirmed diffuse panbronchiolitis (DPB) because of the lymphocytic and plasmacytic infiltrates in the respiratory bronchioles. Her condition improved after the administration of clarithromycin. Several cases of RA complicating DPB have previously been reported, but only in Japan. We need to consider DPB as a bronchiolitis types accompanying RA among Japanese patients.
一位 58 岁的女性类风湿关节炎(RA)患者因持续咳嗽和咳痰一年前来我院就诊。她的冷球蛋白滴度高,并有慢性鼻窦炎。胸部 CT 显示双侧弥漫性中心性结节,支气管扩张和支气管壁增厚。进行了外科肺活检,由于呼吸细支气管中的淋巴细胞和浆细胞浸润,证实为弥漫性泛细支气管炎(DPB)。克拉霉素治疗后,她的病情有所改善。以前曾有报道过几例并发 DPB 的 RA 病例,但仅在日本。我们需要考虑 DPB 作为日本 RA 患者伴随的细支气管炎类型。