Morita S, Sato A, Hayakawa H, Chida K, Sato J, Todate A, Tsukamoto K, Toyoshima M, Imokawa S, Iwata M
Second Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Aug;34(8):921-5.
A 52-year-old man with an 8-year history of rheumatoid arthritis was admitted to the hospital because of coughing and purulent sputum. A chest X-ray film obtained on admission showed small nodular shadows without overinflation in both lower lung fields, and a high-resolution CT scan showed many micronodular shadows in the centrilobular regions. Follicular bronchiolitis was diagnosed from the results of an open-lung biopsy, and prednisolone therapy was started at a dosage of 40 mg/day. Sinusitis developed 4 years later. Five years after the start of steroid therapy, dilation of bronchi and thickening of bronchial walls appeared on a CT scan, which also showed areas of low attenuation that were presumed to be bronchiolitis obliterans. These findings suggest that the pattern of airway disease can vary during the course of rheumatoid arthritis.
一名患有8年类风湿关节炎病史的52岁男性因咳嗽和脓性痰入院。入院时的胸部X线片显示双下肺野有小结节阴影，无肺过度充气，高分辨率CT扫描显示小叶中心区域有许多微小结节阴影。经开胸肺活检结果诊断为滤泡性细支气管炎，并开始以40毫克/天的剂量进行泼尼松龙治疗。4年后发生鼻窦炎。类固醇治疗开始5年后，CT扫描显示支气管扩张和支气管壁增厚，还显示出推测为闭塞性细支气管炎的低衰减区域。这些发现表明，气道疾病的模式在类风湿关节炎病程中可能会有所不同。
