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Bronchiolar disease in rheumatoid arthritis
H Hayakawa1, A Sato, S Imokawa
1Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan.
American Journal of Respiratory and Critical Care Medicine
|November 1, 1996
Summary
Rheumatoid arthritis (RA) patients with follicular bronchiolitis (FB) or bronchiolitis obliterans (BO) often experience chronic cough. Erythromycin (EM) treatment showed symptom improvement in these RA-related lung diseases.
Area of Science:
- Pulmonary Medicine
- Rheumatology
- Pathology
Background:
- Rheumatoid arthritis (RA) can cause pulmonary complications, including follicular bronchiolitis (FB) and bronchiolitis obliterans (BO).
- These bronchiolar diseases in RA patients often present with chronic respiratory symptoms.
Purpose of the Study:
- To investigate the clinical and pathological characteristics of FB and BO in RA patients.
- To evaluate the efficacy of erythromycin (EM) in managing these pulmonary conditions.
Main Methods:
- Study included 15 RA patients with biopsy-proven FB or BO.
- Clinical data, sputum cultures, and high-resolution computed tomography (HRCT) were analyzed.
- Effect of EM therapy was assessed in 11 patients.
Main Results:
- Chronic cough with sputum was a predominant symptom (93%).
- Bacterial cultures were positive in 50% (FB) and 71% (BO) of patients.
- HRCT showed characteristic findings like centrilobular nodules and peribronchial thickening.
- EM therapy led to significant symptom improvement in 11 patients.
- No deaths related to bronchiolar disease occurred during follow-up.
Conclusions:
- RA-associated FB and BO typically follow a chronic course, primarily manifesting as productive cough.
- Erythromycin (EM) may be a beneficial treatment option for managing bronchiolar diseases in RA patients.