CASE REPORT
Bronchiolar disease associated with gold compounds administration in a patient with rheumatoid arthritis
Kazuko Hiramatsu1, 2 , Hiroshi Ishizuka1 and Miyako Yamasaki1
| (1) |
Department of Internal Medicine, Kawasaki Kyodo Hospital, 2-1-5 Sakuramoto, Kawasaki-ku, Kawasaki 210-0833, Japan |
| (2) |
Present address: Department for Rheumatic Diseases, Tokyo Metropolitan Fuchu General Hospital, 2-9-2 Musashidai, Fuchu 183-8524, Japan |
Received: 09 August 2004 Accepted: 13 January 2005
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Abstract We report the case of a female patient with rheumatoid arthritis (RA) treated with gold sodium thiomalate and auranofin who developed bronchopulmonary involvement. Chest X-ray films showed diffuse mottled infiltrates and bronchial wall thickness in both lungs. Computed tomography revealed opacities along the thickening of the bronchovascular bundles. The pathologic findings were indistinguishable from those of diffuse panbronchiolitis. After discontinuation of gold compounds and initiation of steroid administration, her subjective symptoms immediately subsided. We conclude that our patient, who had suffered from chronic sinusitis and had a predisposition to bronchiolar disease, had bronchiolar disease induced by gold compounds.
Key words Bronchiolar disease - Diffuse panbronchiolitis - Disease-modifying antirheumatic drugs (DMARDs) - DMARDs-induced pulmonary injury - Gold compounds - Rheumatoid arthritis (RA)
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