title: [Nodular changes in lungs in a patient with rheumatoid arthritis. Diagnostic and therapeutic difficulties. Case report].
abstract: Rheumatoid arthritis is a systemic inflammatory disease characterized by destructive synovitis and systemic extra-articular involvement exemplified by rheumatoid nodules occurring in the skin, lungs, and other parenchymatous organs. Antirheumatic drugs like methotrexate and leflunomide are known to predispose to the development of pulmonary rheumatoid nodules. We report the case of a 60-year-old male with rheumatoid arthritis previously treated with methotrexate and cyclosporin, in whom multiple pulmonary nodules were disclosed. The patient was extensively diagnosed to exclude any malignancy. Pulmonary rheumatoid nodules were recognized, methotrexate was withdrawn, and cyclophosphamide pulses were started. The size of the nodules decreased and the patient was started on cyclosporin.
authors.affiliation: Klinika Reumatologii i Chorób Wewnetrznych Akademii Medycznej we Wrocławiu ul. Borowska 213, 50-556 Wrocław.
authors.forename: Ewa
authors.initials: E
authors.lastname: Krecipro-Nizińska
authors.forename: Ewa
authors.initials: E
authors.lastname: Morgiel
authors.forename: Helena
authors.initials: H
authors.lastname: Smiechowicz
authors.forename: Piotr
authors.initials: P
authors.lastname: Wiland
mesh_terms: D000368:Aged; D003520:Cyclophosphamide / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D012218:Rheumatoid Nodule / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D016572:Cyclosporine; D003520:Cyclophosphamide; D008727:Methotrexate