[A case of follicular bronchiolitis preceding rheumatoid arthritis].
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.
Kitasato
Yasuhiko
Y
First Department of Internal Medicine, Kurume University School of Medicine.
Nagata
Nobuhiko
N
Ikedou
Yukari
Y
Inoue
Mayumi
M
Matsunaga
Kazuko
K
Tokito
Takaaki
T
Toda
Reiko
R
Gohara
Rumi
R
Emori
Mikiko
M
Hoshino
Tomoaki
T
Kinoshita
Masaharu
M
Koga
Takeharu
T
Aizawa
Hisamichi
H
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