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Necrotizing tracheobronchitis associated with rheumatoid arthritis.
Shigehisa Kajikawa1, Kazushi Noda2, Yasuhiro Nozaki2
1Department of Respiratory Medicine, Tokoname Municipal Hospital, Japan.
Respiratory Medicine Case Reports
|November 30, 2016
Summary
This case study highlights necrotizing tracheobronchitis in a rheumatoid arthritis patient. Systemic inflammation from rheumatoid arthritis caused the rare airway condition, treated successfully with steroids.
Area of Science:
- Pulmonology
- Rheumatology
- Pathology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints.
- Airway involvement in RA is uncommon but can manifest as various pathologies.
- Necrotizing tracheobronchitis is a severe inflammatory condition of the trachea and bronchi.
Observation:
- A 64-year-old male with rheumatoid arthritis presented with worsening respiratory symptoms initially misdiagnosed as community-acquired pneumonia.
- Bronchoscopy revealed necrotic tissue and white, soft lesions in the trachea and bronchi.
- Transbronchial biopsy confirmed necrotic tissue with squamous metaplasia and inflammatory infiltrate.
Findings:
- The patient exhibited high levels of rheumatoid factor and anti-cyclic citrullinated peptide antibodies, confirming rheumatoid arthritis.
- Necrotizing tracheobronchitis was diagnosed as a manifestation of systemic inflammation associated with rheumatoid arthritis.
- The respiratory condition showed acute exacerbation unresponsive to initial antibiotic therapy.
Implications:
- This case underscores the importance of considering systemic autoimmune conditions in unexplained respiratory symptoms.
- Necrotizing tracheobronchitis in the context of rheumatoid arthritis requires a tailored treatment approach.
- Steroid therapy proved effective in managing the airway inflammation and improving respiratory status in this patient.
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