Sumiya M, Ohya N, Shinoura H, Kinoshita M, Aotsuka S, Ishida T, Morita T
Division of Rheumatology, National Medical Center Hospital, Tokyo, Japan.
J Rheumatol. 1996 May;23(5):933-6.
We describe a woman with seronegative rheumatoid arthritis (RA) who presented with diffuse septal pulmonary amyloidosis mimicking interstitial rheumatoid lung disease. Her systemic amyloidosis was diagnosed by biopsy of the kidney, stomach mucosa, and salivary glands 28 years after the onset of RA. Diffuse interstitial pulmonary infiltrates had been noted since that diagnosis, but infiltrates had been considered due to rheumatoid lung. Results of pulmonary function tests, which revealed restrictive changes and decreased diffusion capacity, were also compatible with rheumatoid lung disease. Pulmonary amyloidosis was diagnosed at autopsy. Pulmonary amyloidosis should be considered a cause of pulmonary infiltrates in patients with longstanding RA.
我们描述了一名血清阴性类风湿关节炎（RA）女性患者，其表现为弥漫性间隔性肺淀粉样变性，酷似间质性类风湿肺病。她的系统性淀粉样变性在类风湿关节炎发病28年后通过肾脏、胃黏膜和唾液腺活检得以诊断。自该诊断以来就已注意到弥漫性间质性肺部浸润，但一直认为浸润是由类风湿肺病所致。肺功能测试结果显示为限制性改变和弥散能力下降，这也与类风湿肺病相符。尸检时诊断为肺淀粉样变性。对于长期患类风湿关节炎的患者，应考虑肺淀粉样变性是肺部浸润的一个病因。
