Pulmonary Involvement inRheumatoid Arthritis

Authors: A. Kohout;  M. Rešl;  M. Báčová
Authors‘ workplace: Fingerladův ústav patologie, LF UK a FN, Hradec Králové II. interní klinika LF UK a FN, Hradec Králové
Published in: Čes.-slov. Patol., , 2001, No. 3, p. 105-107


A 78-year-old smoker with a medical history of rheumatoid arthritis (RA) diagnosed 23 yearsbefore death and treated for 10 years by sulfasalazine followed by 7 years of therapy by purineantimetabolite (AZAMUN, Leiras Co.). Two years before his death chemotherapy was added totreat a low grade malignant lymphoma. Pulmonary changes revealed during autopsy consisted ofdiffuse interstitial fibrosis, diffuse alveolar damage in its acute to subacute phase, and massivemultiple bilateral ossifications. The possible side effect of RA treatment on pulmonary tissue isdiscussed. Post mortem low-voltage X-ray examination appears as a method which may contribute to the accurate distribution and correct diagnosis of multiple pulmonary ossification.

Key words:
lung - lung fibrosis - diffuse alveolar damage - lung ossification - sulfasalazine -antimetabolites - cyclophosphamide

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Anatomical pathology Forensic medical examiner Toxicology
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