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Empyema in rheumatoid arthritis

P A Dieppe

    Annals of the Rheumatic Diseases
    |April 1, 1975
    PubMed

    Insights

    Rheumatoid arthritis (RA) can lead to two types of nontuberculous empyema, sometimes with lung nodules or as large, recurrent infections. Middle-aged men with active RA are particularly susceptible to these serious pleural infections.

    Area of Science:

    • Pulmonology
    • Rheumatology
    • Infectious Diseases

    Background:

    • Nontuberculous empyema is a serious thoracic infection.
    • Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting joints and potentially other organs.
    • The association between RA and empyema is not well-established, necessitating further investigation.

    Purpose of the Study:

    • To investigate the occurrence and characteristics of nontuberculous empyema in patients with rheumatoid arthritis.
    • To review existing literature on the link between RA and empyema.
    • To identify distinct patterns of empyema in RA patients.

    Main Methods:

    • Retrospective case review of 67 patients with nontuberculous empyema at Brompton Hospital.
    • Inclusion criteria: absence of malignant disease.
    • Analysis of three identified cases of empyema associated with RA.

    Main Results:

    • Three cases of nontuberculous empyema in patients with RA were identified.
    • Two distinct patterns of empyema in RA were observed: 1) associated with nodular pleuropulmonary disease and pyopneumothoraces, and 2) large, recurrent primary empyemas in the presence of active RA.
    • Middle-aged men showed a higher susceptibility, similar to rheumatoid pleural effusions.

    Conclusions:

    • Rheumatoid arthritis is associated with specific types of nontuberculous empyema.
    • Empyema in RA patients can manifest with or without pleuropulmonary nodules.
    • Active rheumatoid disease and nodular lung disease are key factors in RA-associated empyema development.

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