Rheumatoid nodules in the lung parenchyma in rheumatoid arthritis

Rheumatoid nodules (RNs) are one of the most common extra-articular manifestations of rheumatoid arthritis (RA), but are rarely located in lung tissue. The development of extra-articular (systemic) manifestations of RA is associated with the high levels of rheumatoid factor and anticyclic citrullina...

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Main Authors: A. M. Satybaldyev, L. P. Ananyeva
Format: Article
Language:Russian
Published: IMA PRESS LLC 2019-07-01
Series:Научно-практическая ревматология
Subjects:
Online Access:https://rsp.mediar-press.net/rsp/article/view/2738
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author A. M. Satybaldyev
L. P. Ananyeva
author_facet A. M. Satybaldyev
L. P. Ananyeva
author_sort A. M. Satybaldyev
collection DOAJ
description Rheumatoid nodules (RNs) are one of the most common extra-articular manifestations of rheumatoid arthritis (RA), but are rarely located in lung tissue. The development of extra-articular (systemic) manifestations of RA is associated with the high levels of rheumatoid factor and anticyclic citrullinated peptide antibodies. The specific features of the course of RNs in lung tissue are their frequent occurrence with minimally pronounced joint inflammatory changes or remission. In rare cases, RNs are prone to disintegration and suppuration, which may be complicated by the formation of small caverns, hemoptysis, and, if located subpleurally, pneumothorax. In addition, there are publications on the possible relationship of the formation of RNs and their accelerated development to the administration of immunosuppressive drugs (methotrexate, tocilizumab, D-penicillamine, gold salts, leflunomide, infliximab, and other TNF-α inhibitors) and on the association of pulmonary RNs with methotrexate treatment. The paper describes a clinical case of a female patient with RA-systemic sclerosis overlap syndrome and RN formation in lung tissue early at disease onset when the DAS28 target level for RA has been achieved. The atypical outline of a pulmonary nodule has required a differential diagnostic search. The results of imaging RNs in the lung and their dynamics are shown. The given data are discussed.
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spelling doaj.art-1d61995a65e44244be658ab1e23506f32023-03-22T13:45:55ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922019-07-0157334935510.14412/1995-4484-2019-349-3552502Rheumatoid nodules in the lung parenchyma in rheumatoid arthritisA. M. Satybaldyev0L. P. Ananyeva1V.A. Nasonova Research Institute of RheumatologyV.A. Nasonova Research Institute of RheumatologyRheumatoid nodules (RNs) are one of the most common extra-articular manifestations of rheumatoid arthritis (RA), but are rarely located in lung tissue. The development of extra-articular (systemic) manifestations of RA is associated with the high levels of rheumatoid factor and anticyclic citrullinated peptide antibodies. The specific features of the course of RNs in lung tissue are their frequent occurrence with minimally pronounced joint inflammatory changes or remission. In rare cases, RNs are prone to disintegration and suppuration, which may be complicated by the formation of small caverns, hemoptysis, and, if located subpleurally, pneumothorax. In addition, there are publications on the possible relationship of the formation of RNs and their accelerated development to the administration of immunosuppressive drugs (methotrexate, tocilizumab, D-penicillamine, gold salts, leflunomide, infliximab, and other TNF-α inhibitors) and on the association of pulmonary RNs with methotrexate treatment. The paper describes a clinical case of a female patient with RA-systemic sclerosis overlap syndrome and RN formation in lung tissue early at disease onset when the DAS28 target level for RA has been achieved. The atypical outline of a pulmonary nodule has required a differential diagnostic search. The results of imaging RNs in the lung and their dynamics are shown. The given data are discussed.https://rsp.mediar-press.net/rsp/article/view/2738rheumatoid arthritisoverlap syndromesystemic sclerosisextra-articular manifestationsrheumatoid nodulesmethotrexateleflunomidesulfasalazinepulmonary nodules
spellingShingle A. M. Satybaldyev
L. P. Ananyeva
Rheumatoid nodules in the lung parenchyma in rheumatoid arthritis
Научно-практическая ревматология
rheumatoid arthritis
overlap syndrome
systemic sclerosis
extra-articular manifestations
rheumatoid nodules
methotrexate
leflunomide
sulfasalazine
pulmonary nodules
title Rheumatoid nodules in the lung parenchyma in rheumatoid arthritis
title_full Rheumatoid nodules in the lung parenchyma in rheumatoid arthritis
title_fullStr Rheumatoid nodules in the lung parenchyma in rheumatoid arthritis
title_full_unstemmed Rheumatoid nodules in the lung parenchyma in rheumatoid arthritis
title_short Rheumatoid nodules in the lung parenchyma in rheumatoid arthritis
title_sort rheumatoid nodules in the lung parenchyma in rheumatoid arthritis
topic rheumatoid arthritis
overlap syndrome
systemic sclerosis
extra-articular manifestations
rheumatoid nodules
methotrexate
leflunomide
sulfasalazine
pulmonary nodules
url https://rsp.mediar-press.net/rsp/article/view/2738
work_keys_str_mv AT amsatybaldyev rheumatoidnodulesinthelungparenchymainrheumatoidarthritis
AT lpananyeva rheumatoidnodulesinthelungparenchymainrheumatoidarthritis