Aratake K, Eguchi K, Migita K, Kawabe Y, Matsuoka N, Tominaga M, Nakamura H, Ichinose K, Nagataki S, Toriyama K
First Department of Internal Medicine, Nagasaki University School of Medicine.
Nihon Rinsho Meneki Gakkai Kaishi. 1998 Jun;21(3):129-36. doi: 10.2177/jsci.21.129.
An autopsy case of rheumatoid arthritis (RA) with acute exacerbation of interstitial pneumonia is reported. A 57-year-old woman with longstanding RA was admitted to our hospital because of progressive dyspnea. On chest roentogenogram, diffuse interstitial shadow was confirmed in both lungs. Chest computed tomography (CT) showed diffuse lesion of elevated density of CT level in both lung. She was diagnosed as an acute exacerbation of interstitial pneumonia, and treated by methylpredonisolone pulse therapy (1,000 mg/day). Although cyclosporin A (2 mg/kg/day) was combined to steroid therapy, she was died of progressive respiratory failure. The histological findings of the lung showed extensive fibrosis with alveolar damage associated with hyaline membranes, edema and hemorrhage in alveolar space.
报告了1例类风湿关节炎(RA)合并间质性肺炎急性加重的尸检病例。一名患有长期RA的57岁女性因进行性呼吸困难入住我院。胸部X线片显示双肺弥漫性间质阴影。胸部计算机断层扫描(CT)显示双肺CT值密度升高的弥漫性病变。她被诊断为间质性肺炎急性加重,并接受甲泼尼龙冲击治疗(1000mg/天)。尽管联合环孢素A(2mg/kg/天)进行类固醇治疗,但她死于进行性呼吸衰竭。肺组织学检查结果显示广泛纤维化,伴有肺泡损伤,伴有透明膜、肺泡腔水肿和出血。