Apical fibrobullous disease with rheumatoid arthritis

We describe a patient who developed noninfectious apical fibrobullous disease 12 years after the diagnosis of seropositive, nodular, deforming rheumatoid arthritis. Fibrobullous disease of the pulmonary apices is a rare entity that is usually found in association with ankylosing spondylitis. Its appearance with rheumatoid arthritis has not been reported. Speculative factors which may predispose to apical fibrobullous disease, such as a stiff chest wall, impaired esophageal motiligy, and HL-A antigen B27, were not present in our patient.