title: [A case of follicular bronchiolitis preceding rheumatoid arthritis].
abstract: A 52-year-old woman was admitted to Yame General Hospital because of persistent cough, wheeze, and shortness of breath at age 48. Chest X-ray and computed tomography (CT) showed bilateral centrilobular shadows. Pulmonary function test revealed obstructive dysfunction. She also had chronic sinusitis. Initially, diffuse panbronchiolitis was diagnosed and she was given macrolides, but no improvement was observed. Thus video-assisted thoracoscopic lung biopsy (VATS) was performed in order to establish a definitive diagnosis. Histopathological findings were compatible with a diagnosis of follicular bronchiolitis. Treatment with corticosteroid (oral prednisolone, 50 mg/day) improved her condition. However, on reducing the steroid doze, her symptoms and chest X-ray film/CT findings became exacerbated. In addition, polyarthritis appeared. Further investigations revealed a diagnosis of rheumatoid arthritis. Only 2 cases of follicular bronchiolitis preceding rheumatoid arthritis have been reported in Japan.
authors.affiliation: First Department of Internal Medicine, Kurume University School of Medicine.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitasato
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nagata
authors.forename: Yukari
authors.initials: Y
authors.lastname: Ikedou
authors.forename: Mayumi
authors.initials: M
authors.lastname: Inoue
authors.forename: Kazuko
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tokito
authors.forename: Reiko
authors.initials: R
authors.lastname: Toda
authors.forename: Rumi
authors.initials: R
authors.lastname: Gohara
authors.forename: Mikiko
authors.initials: M
authors.lastname: Emori
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Hoshino
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Takeharu
authors.initials: T
authors.lastname: Koga
authors.forename: Hisamichi
authors.initials: H
authors.lastname: Aizawa
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000000981:diagnostic imaging; D001988:Bronchiolitis / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D014057:Tomography, X-Ray Computed