Rheumatoid arthritis, a systemic inflammatory disease, may induce pulmonary manifestations. We describe a case of longstanding RA presenting with eosinophilic pneumonia. Rare case reports of tissue eosinophilia involving isolated organs in the setting of rheumatoid arthritis exist in the literature. It has been shown that the production of proinflammatory cytokines activates different cell group and can simultaneously play a role in rheumatoid arthritis, and induce eosinophils infiltration in target tissue. An appropriate lowest possible dosage of steroid therapy is essential, whereas eosinophilic pneumonia may be a rare subset of pulmonary involvement in rheumatoid arthritis.
LEARNING POINTS• The lungs and pleura are frequently involved in rheumatoid arthritis and contribute between 10% and 20% of overall mortality.• A patient with rheumatoid arthritis presenting with respiratory symptoms, serum eosinophilia and specific pulmonary radiological involvement, can in rare cases have eosinophilic pneumonia. • There may be an association between hypereosinophilia and immunological alteration in rheumatoid arthritis.• In this patient, treatment with prednisone and hydroxychloroquine achieved clinical remission.