Rheumatoid arthritis with diffuse pulmonary rheumatoid nodules
Rheumatoid arthritis with diffuse pulmonary rheumatoid nodules
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DOI：
10.1111/j.1440-1827.2004.01758.x
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发表时间：
2004-10-01
影响因子：
2.2
通讯作者：
Mori, N
中科院分区：
文献类型：
--
作者：
Kitamura, A;Matsuno, T;Mori, N
真皮或皮下组织中的类风湿结节虽然是类风湿性关节炎的征兆，但非常罕见。通过活检和肺组织的尸检材料来识别这些类风湿结节甚至更不常见。这些结节可能是单发或多发，很少会引起呼吸道症状。本文报告一例弥漫性肺类风湿性结节及双肺间质纤维化的病例。患者有关节症状和血清阳性，临床病程很快，在出现呼吸困难3个月后死于呼吸衰竭。胸片显示间质性肺炎伴双侧弥漫性周边阴影。在尸检中，大量类风湿结节和间质纤维化破坏了两个肺，以至于没有残留的正常肺组织。据信，这是一个极其罕见的病例，在整个肺部都有大量的类风湿结节。这位患者的研究结果表明，在类风湿关节炎患者中，临床间质性肺炎经放射学证实并不排除类风湿肺结节的存在。
Rheumatoid nodules in dermal or subcutaneous tissues, while indicative of rheumatoid arthritis, are very rare. It is even less common to identify these rheumatoid nodules by biopsy as well as in autopsy materials from lung tissue. These nodules may be single or multiple, which seldom cause respiratory symptoms. Here, a patient with diffuse pulmonary rheumatoid nodules and interstitial fibrosis throughout both lungs, is described. The patient, with articular symptoms and seropositivity, exhibited a rapid clinical course and died of respiratory failure 3 months after the appearance of dyspnea. Chest radiography indicated interstitial pneumonitis with bilateral diffuse peripheral shadows. At autopsy, numerous rheumatoid nodules and interstitial fibrosis had destroyed both lungs, such that no residual normal pulmonary tissue remained. It is believed that this was an extremely rare case exhibiting large numbers of rheumatoid nodules throughout the lungs. Findings with this patient indicate that, in patients with rheumatoid arthritis, clinical interstitial pneumonitis confirmed radiologically does not exclude the existence of rheumatoid lung nodules.