Recurrent Pneumothorax in a Patient With Rheumatoid Arthritis

Adelman, Harold M.; Dupont, Elisabeth; Flannery, Michael T.; Wallach, Paul M.

doi:10.1097/00000441-199409000-00009

Cited by 27 publications

(13 citation statements)

References 4 publications

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“…It is thought to occur in approximately 5% of patients with rheumatoid lung [36] and is found on chest radiography in 6% of patients with rheumatoid effusions [33]; it may be bilateral [24] or recurrent [37]. Pneumothoraces are thought to derive from perforation of cavitating rheumatoid nodules into the pleural space, creating continuous leakage.…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

Pleural Involvement in Systemic Autoimmune Disorders

2008

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Systemic autoimmune diseases, a heterogeneous group of immunologically mediated inflammatory disorders including multiorgan involvement, can affect the pleura with various frequencies, either as a single presenting feature or as part of multisystem involvement. Rheumatoid arthritis and systemic lupus erythematosus represent the most common immunological diseases that affect the pleural cavity; however, there is considerable variation regarding the reported prevalence, natural history and prognosis of pleural involvement in both conditions. The definition of pleural disease in the remaining systemic autoimmune disorders is unquestionably imprecise and assumptive, since it is risky to support premises based on single case reports or retrospective data from very small series. In this article, we will review the manifestations of pleural disease caused by rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyositis/dermatomyositis, mixed connective tissue disease, ankylosing spondylitis, Sjögren’s syndrome and Wegener’s granulomatosis.

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Section: Rheumatoid Arthritismentioning

confidence: 99%

Pleural Involvement in Systemic Autoimmune Disorders

2008

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“…First, the patient presented with recurrent spontaneous pneumothorax, probably secondary to a bronchopleural fistula, a rare but well recognised complication of rheumatoid nodule. 5 Second, the presence of fungi in a pulmonary rheumatoid nodule is an extremely unusual phenomenon that, to the best of our knowledge, has been reported only once in the English language literature. 6 Although in our case the fungi were morphologically consistent with aspergillus, the lack of culture confirmation precludes a firm conclusion about their exact classification.…”

Section: Discussionmentioning

confidence: 85%

Fungus colonisation of pulmonary rheumatoid nodule

Cavazza¹,

Paci²,

Turrini³

et al. 2003

Journal of Clinical Pathology

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This report describes a 69 year old woman, suffering from active rheumatoid arthritis since the age of 60 and presenting with severe dyspnoea and cough. A computed tomography scan of the chest showed multiple bilateral pulmonary nodules, sometimes cavitated, associated with reticular opacities and pleural effusion. A videothoracoscopic excision of a cavitated nodule was performed. Seven days after surgery, a right pneumothorax developed, and the patient died of septicaemia one month later. Microscopically, the excised nodule was composed of necrotic fibrinoid material with a peripheral rim of palisaded histiocytes, extending to the pleural surface and containing several fungal hyphae morphologically consistent with aspergillus. A diagnosis of pulmonary rheumatoid nodule with fungus colonisation was made. In the lung, fungus colonisation is a rare complication of rheumatoid nodules. The most important differential diagnostic considerations are briefly discussed.A wide spectrum of pleuropulmonary lesions are recognised in patients with rheumatoid arthritis. These include pleuritis, interstitial lung disease, bronchiolitis, vascular lesions, and rheumatoid nodules.

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“…Pulmonary involvement is among the systemic findings in RA and could be seen as pleural effusion, bronchiolitis obliterans, pulmonary hypertension, interstitial lung disease, bronchiolitis obliterans-organized pneumonia and necrobiotic nodules [14,15]. nature, risk factors include male sex, longer disease duration, presence of subcutaneous rheumatoid nodules, rheumatoid factor positivity and smoking [16].…”

Section: Discussionmentioning

confidence: 99%