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Related Experiment Videos

Rheumatoid nodules in the trachea

M S Ip1, M P Wong, K L Wong

  • 1Department of Medicine, University of Hong Kong, Queen Mary Hospital.

Chest
|January 1, 1993
PubMed
Summary

The first endotracheal rheumatoid nodules were found in a rheumatoid arthritis patient. Treatment with prednisone led to the regression of both tracheal and subcutaneous nodules.

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Area of Science:

  • Rheumatology
  • Pulmonology
  • Pathology

Background:

  • Rheumatoid arthritis is a chronic autoimmune disease primarily affecting joints.
  • Rheumatoid nodules are common extra-articular manifestations, typically found subcutaneously.
  • Endotracheal involvement is an extremely rare presentation of rheumatoid arthritis.

Observation:

  • A 45-year-old Chinese male with a history of rheumatoid arthritis presented with worsening polyarthritis.
  • He also developed new subcutaneous nodules and signs of fibrosing alveolitis.
  • Bronchoscopy revealed four whitish nodules on the tracheal wall.

Findings:

  • Biopsy of the tracheal nodules confirmed features of rheumatoid nodules, including fibrinoid necrosis, inflammatory cell infiltrate, and vasculitis.
  • This represents the first documented case of endotracheal rheumatoid nodules.
  • The patient's symptoms and nodules showed regression upon treatment with oral prednisone.

Implications:

  • This case expands the spectrum of potential respiratory manifestations in rheumatoid arthritis.
  • It highlights the importance of considering rheumatoid nodules in the trachea for patients with severe rheumatoid arthritis and respiratory symptoms.
  • Early diagnosis and treatment may prevent airway compromise and improve outcomes.

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