Open AccessComplicated Rheumatoid Nodules in Lung
Author(s) -
Geetha Wickrematilake
Publication year - 2020
Publication title -
case reports in rheumatology
Language(s) - English
Resource type - Journals
eISSN - 2090-6889
pISSN - 2090-6897
DOI - 10.1155/2020/6627244
Subject(s) - medicine , hydroxychloroquine , rheumatoid nodule , rheumatoid arthritis , tocilizumab , rituximab , leflunomide , radiology , lung , pneumothorax , lymphoma , covid-19 , disease , infectious disease (medical specialty)
A 65-year-old nonsmoker lady carrying a diagnosis of seropositive erosive rheumatoid arthritis for nine years presented with acute shortness of breath, following a spontaneous pneumothorax while on combination therapy with methotrexate, leflunomide, and tocilizumab. Imaging studies revealed multiple cavitory lung nodules, and a transbronchial lung biopsy favoured a diagnosis of rheumatoid lung nodules. Her initial pathological samples were negative for any infectious cause. A follow-up computerized tomography scan (CT scan) confirmed enlargement of lung nodules with a positive antibody test for aspergillosis which needed antifungal therapy, and currently, her arthritis is managed well with rituximab therapy, sulfasalazine, and hydroxychloroquine.