Intensive immunosuppressive therapy for endogenous lipoid pneumonia associated with rheumatoid arthritis

Abstract

Endogenous lipoid pneumonia is an uncommon inflammatory pulmonary disease that is caused by lipids from an endogenous source, the treatment for which has not been established. We report the first case of endogenous lipoid pneumonia presenting as lung consolidation and which was associated with rheumatoid arthritis. Treatment was successful with intensive immunosuppressive therapy. When a physician finds lung consolidation in a patient with active rheumatic disease, lipoid pneumonia should be considered.

Lipoid pneumonia induced by aspiration of liquid paraffin

“…Patients with RA may develop a range of pulmonary diseases, such as airway diseases, interstitial lung diseases, and pleuritis. When lung consolidation is detected in the presence of active rheumatic disease, lipoid pneumonia should be considered as a potential diagnosis [11].…”

Adult Onset Still Disease Associated with Endogenous Lipoid Pneumonia

“…Since many of the ELP cases occur in the context of another underlying disease, the treatment should be focused on that disease. The systemic corticosteroid, TNFa antagonist, intravenous immunoglobulins [IVIg], and complete lavage of the lungs are the methods that have been used for treatment to date [9][10][11]. If ELP emerges as a post-obstruction case, removing the obstruction or frequent lavage of the lungs will serve as the best treatment method [1].…”

“…In the cases in which the disease emerges as a mass and is diagnosed by biopsy, it is not certainly known whether the mass removal is necessary or not. However, in the cases of extensive disease, particularly when it is associated with systemic diseases and the patient is symptomatic, prescription of the immunosuppressive drugs has been proved to be successful in some instances [9].…”