类风湿关节炎相关复发性胸腔积液。

Rheumatoid arthritis associated recurrent pleural effusion.

作者信息

Abbas Ramsha, Khan Muhammad Ahmed, El Khoury Anthony, AlMahdy AlBatool, Hishmeh Mohammad Abu

机构信息

Department of Internal Medicine, UMass Chan Medical School-Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA.

Department of Pulmonary & Critical Care Medicine, UMass Chan Medical School-Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA.

出版信息

Respir Med Case Rep. 2024 Oct 5;52:102129. doi: 10.1016/j.rmcr.2024.102129. eCollection 2024.

DOI:10.1016/j.rmcr.2024.102129

PMID:39498239

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11532488/

Abstract

Pleural effusions and pulmonary nodules are known complications of rheumatoid arthritis (RA) though pleural extra-articular manifestations without clinical arthritis are rare. We present a 66-year-old male with dyspnea and weight loss, whose imaging revealed pleural effusions and lung nodules, multiple exudative pleural effusions, and a thoracoscopic biopsy showing chronic pleuritis and granulomatous inflammation. Subsequent joint stiffness and positive rheumatoid markers led to a RA diagnosis. Patient received prednisone and methotrexate, leading to symptomatic improvement but with recurrent pleural effusions, requiring regular thoracenteses. RA can cause pleural effusions and lung nodules without arthritis necessitating advanced treatments for persistent effusions.

摘要

胸腔积液和肺结节是类风湿关节炎（RA）已知的并发症，尽管无临床关节炎表现的胸膜关节外表现较为罕见。我们报告一名66岁男性，有呼吸困难和体重减轻症状，其影像学检查显示有胸腔积液和肺结节、多处渗出性胸腔积液，胸腔镜活检显示为慢性胸膜炎和肉芽肿性炎症。随后出现的关节僵硬和类风湿因子阳性导致了RA的诊断。患者接受了泼尼松和甲氨蝶呤治疗，症状有所改善，但胸腔积液反复出现，需要定期进行胸腔穿刺。RA可导致无关节炎表现的胸腔积液和肺结节，对于持续性积液需要采取进一步治疗。