Pneumonitis acute rheumatoid

The most common CTD throughout the world is rheumatoid arthritis (RA). Thoracic manifestations of RA are numerous (Table 1) including forms of ILD. The thoracic disease manifestations independent of ILD include pleural effusions, bronchiolitis obliterans (BO) without an organizing pneumonia, rheumatoid nodules, upper airway obstruction, and acute rheumatoid pneumonitis. 

Respiratory A 52-year-old woman with psoriatic arthritis developed pneumonitis after taking leflunomide for 5 months [63 ]. Several cases of acute interstitial pneumonitis complicating leflunomide treatment for rheumatoid arthritis have been described in Japanese populations, but this complication appears to be extremely rare in the Western hemisphere. 

Respiratory Adalimumab-induced acute pneumonitis and interstitial pneumonia have been reported in two patients with rheumatoid arthritis [24, 25 ]. 

Dascalu C, Mrejen-Shakin K, Bandagi S. Adalimumab-induced acute pneumonitis in a patient with rheumatoid arthritis. J Clin Rheumatol 2010 16(4) 172-A. 

A rare form of rheumatoid involvement of the lung is an acute pneumonitis characterized by diffuse alveolar damage (24). Some cases of this disorder have occurred within a week of stopping corticosteroids with a presentation akin to the acute respiratory distress syndrome (ARDS). 

D-Penicillamine is used in the treatment of rheumatoid arthritis. Several types of pulmonary toxicities have been described with this agent. A pulmonary-renal syndrome similar to Goodpasture s syndrome has been rarely described and is fatal in 50% of the cases. Hemoptysis and hematuria are present in an acute fashion and warrant prompt discontinuation of the drug. Anti-glomerular basement membrane antibodies are not found and the role of plasmapheresis in undetermined. Treatment with corticosteroids or immunosuppressive agents may be of benefit (21). Bronchiolitis obliterans with or without organizing pneumonia has also been reported, but is also described with rheumatoid arthritis. Hypersensitivity pneumonitis and the subacute onset of pulmonary fibrosis have been... 

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