Sato Fumikazu, Yamano Takahiro, Manbo Yoshimi, Sakaguchi Kimikazu, Yamaguchi Kaori, Miyake Taito
Department of Nephrology and Rheumatology, Koseiren Takaoka Hospital, Takaoka, Toyama, Japan.
Department of Ophthalmology, Koseiren Takaoka Hospital, Takaoka, Toyama, Japan.
Oxf Med Case Reports. 2023 Jan 18;2023(1):omac155. doi: 10.1093/omcr/omac155. eCollection 2023 Jan.
Seronegative rheumatoid arthritis (RA) is less likely to have extra-articular manifestations than seropositive RA. An 80-year-old man with polyarthritis was diagnosed with seronegative RA in which rheumatoid factors and anti-cyclic citrullinated peptides were not detected. He had multiple pulmonary nodules that diminished in size following treatment for RA, leading to the diagnosis of pulmonary rheumatoid nodules. During his treatment course, he developed scleritis, which could have resulted in blindness. As oral steroids did not improve his condition, topical steroid injections were administered, and his symptoms gradually improved. Here, we present a case of seronegative RA with an unusual combination of extra-articular manifestations: rheumatoid pulmonary nodules and scleritis.
血清阴性类风湿关节炎(RA)比血清阳性RA出现关节外表现的可能性更小。一名80岁的多关节炎男性被诊断为血清阴性RA,未检测到类风湿因子和抗环瓜氨酸肽。他有多个肺结节,在接受RA治疗后结节大小缩小,从而诊断为肺类风湿结节。在治疗过程中,他出现了巩膜炎,可能导致失明。由于口服类固醇未能改善其病情,遂给予局部类固醇注射,其症状逐渐改善。在此,我们报告一例血清阴性RA合并不寻常关节外表现组合的病例:类风湿肺结节和巩膜炎。