Delcambre B, Siame J L, Tonnel A B, Lafitte J J, Duquesnoy B, Thevenon A, Tidjani O
Rev Rhum Mal Osteoartic. 1980 Nov;47(11):621-9.
The extra-articular manifestations of RA are numerous and various. Among the latter, pleural involvement is not exceptional, but it is often overlooked for it may be latent. There have been few recent studies of this relationship. The authors report 13 cases of rheumatoid pleurisy collected over the last 7 years in rheumatology and chest units. They recall the frequency of pleurisy, their constitutional background, their clinical and radiological appearances and emphasise the diagnostic interest of a biochemical study of the pleural fluid: a fall in the glucose content and of complement levels are the main changes. A study of the complement system carried out in 11 patients showed a fall in total complement and of the C3 and C4 fractions in the pleural fluid, which shows local consumption of immunological origin. This factor and the clinical picture may be important in diagnosis. The course of these pleural effusions is favourable, complications are exceptional; their treatment is mainly the basic treatment of RA.
类风湿关节炎的关节外表现多种多样。其中,胸膜受累并不罕见,但因其可能隐匿而常被忽视。近期关于这种关系的研究较少。作者报告了过去7年在风湿病科和胸科收集的13例类风湿性胸膜炎病例。他们回顾了胸膜炎的发生率、患者的体质背景、临床和放射学表现,并强调了胸水生化检查在诊断中的意义:葡萄糖含量降低和补体水平下降是主要变化。对11例患者进行的补体系统研究显示,胸水总补体及C3、C4成分下降,表明存在免疫源性局部消耗。这一因素及临床表现对诊断可能很重要。这些胸腔积液病程良好,并发症罕见;其治疗主要是类风湿关节炎的基础治疗。