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Rheumatoid arthritis with diffuse pulmonary rheumatoid nodules
Atsuko Kitamura1, Tadakatsu Matsuno, Michihiko Narita
1Department of Pathology of Biological Response, Nagoya University Graduate School of Medicine, Nagoya, Japan. atsukok@med.nagoya-u.ac.jp
Pathology International
|October 16, 2004
Summary
This rare case highlights diffuse pulmonary rheumatoid nodules, a serious complication of rheumatoid arthritis. Even with interstitial lung disease, rheumatoid nodules can be present and rapidly fatal.
Area of Science:
- Rheumatology
- Pulmonology
- Pathology
Background:
- Rheumatoid nodules are uncommon manifestations of rheumatoid arthritis, rarely found in lung tissue.
- Pulmonary involvement in rheumatoid arthritis typically presents as interstitial lung disease.
Observation:
- A patient with rheumatoid arthritis presented with diffuse pulmonary rheumatoid nodules and interstitial fibrosis.
- The patient experienced rapid clinical deterioration, succumbing to respiratory failure within 3 months of dyspnea onset.
Findings:
- Autopsy revealed extensive rheumatoid nodules and interstitial fibrosis, destroying both lungs.
- Radiological findings of interstitial pneumonitis did not preclude the presence of rheumatoid lung nodules.
Implications:
- This case underscores the importance of considering rheumatoid lung nodules in rheumatoid arthritis patients with interstitial pneumonitis.
- Aggressive, widespread rheumatoid nodules can lead to rapid respiratory failure, even in the absence of typical nodule symptoms.