title: Necrotizing tracheobronchitis associated with rheumatoid arthritis.
abstract: We report a case of necrotizing tracheobronchitis with rheumatoid arthritis. A 64 year-old-man presented with dry cough and was initially diagnosed with community-acquired pneumonia. The patient was admitted; he received initial antibiotic treatment. The treatment was effective and the symptoms worsened. Bronchoscopy was performed for more thorough examination. It showed that white and soft tissues were on the trachea-bronchus. Transbronchial biopsy of the tracheal lesions revealed necrotic tissue with squamous metaplasia and inflammatory cells. Whereas, symmetrical arthralgia of multiple joints of the limbs was noted and rheumatoid factor and anti-cyclic citrullinated peptide antibody of levels were high. According to these results, the patient was diagnosed with rheumatoid arthritis. In this case, necrotizing tracheobronchitis occurred as a result of systemic inflammation associated with rheumatoid arthritis. An acute exacerbation of the patient's respiratory condition was treated with steroid therapy. Tracheal findings and respiratory symptoms were improved by steroid therapy.
authors.affiliation: Department of Respiratory Medicine, Tokoname Municipal Hospital, Japan.
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Kajikawa
authors.affiliation: Department of Respiratory Medicine, Chukyo Hospital, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Noda
authors.affiliation: Department of Respiratory Medicine, Chukyo Hospital, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nozaki
keywords: Bronchoscopy; Necrotizing tracheobronchitis; Rheumatoid arthritis