title: Combined Pulmonary Fibrosis and Emphysema Preceding Lupus Pleuritis.
abstract: An 83-year-old man, who was a former smoker, with anti-ribonucleoprotein (RNP) antibody-positive combined pulmonary fibrosis and emphysema presented with a cough and dyspnea. A chest radiograph showed bilateral pleural effusions. His laboratory data showed proteinuria and elevated levels of anti-nuclear antibodies, anti-double strand DNA antibodies, and CA125, with decreased serum complement levels. Thoracentesis showed an exudative pleural effusion with an increased lymphocyte count and elevated CA125 levels. A thoracoscopic biopsy specimen showed proliferation of CA125-positive mesothelial cells. Systemic lupus erythematosus was diagnosed. His symptoms and pleural effusion resolved after the initiation of systemic corticosteroid therapy. The detection of anti-RNP antibody and CA125 levels are helpful in the diagnosis of lupus pleuritis.
authors.affiliation: Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kamiya
authors.forename: Mikio
authors.initials: M
authors.lastname: Toyoshima
authors.forename: Norimichi
authors.initials: N
authors.lastname: Akiyama
authors.forename: Takafumi
authors.initials: T
authors.lastname: Suda
mesh_terms: D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear; D018394:CA-125 Antigen / Q000276:immunology; D015941:Complement Hemolytic Activity Assay; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D010996:Pleural Effusion / Q000150:complications*; D010998:Pleurisy / Q000175:diagnosis* / Q000188:drug therapy; D011656:Pulmonary Emphysema / Q000150:complications*; D011658:Pulmonary Fibrosis / Q000150:complications*; D012261:Ribonucleoproteins / Q000276:immunology; D000069258:Thoracentesis
chemical_list: D000974:Antibodies, Antinuclear; D018394:CA-125 Antigen; D005938:Glucocorticoids; D012261:Ribonucleoproteins