Bucillamine-induced Pneumonitis in a Patient with Rheumatoid Arthritis-associated Interstitial Pneumonia: A Case Report and Review of the Literature

An 81-year-old woman with rheumatoid arthritis (RA) who had been treated with bucillamine presented with dyspnea. Computed tomography of the chest showed ground-glass opacities and consolidations in both lungs and honeycombing in both basal lung areas. An elevation of the serum Krebs von den Lungen-...

Full description

Saved in:
Bibliographic Details
Published in:Internal Medicine 2019/08/01, Vol.58(15), pp.2207-2211
Main Authors: Fukada, Atsuki, Toyoshima, Mikio, Nozue, Tsuyoshi, Suda, Takafumi
Format: Article
Language:English
Subjects:
Aged, 80 and over
Alveoli
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - drug therapy
Biopsy
Bronchoalveolar Lavage Fluid - cytology
Bronchus
bucillamine-induced pneumonitis
Case Report
CD4 antigen
CD8 antigen
Computed tomography
Corticosteroids
Cysteine - adverse effects
Cysteine - analogs & derivatives
Cysteine - therapeutic use
Dyspnea
Dyspnea - pathology
Female
Humans
Hypoxemia
Hypoxia - complications
Internal medicine
interstitial pneumonia
Literature reviews
Lung - pathology
Lung Diseases, Interstitial - complications
Lung Diseases, Interstitial - diagnosis
Lungs
Lymphocyte Count
Lymphocytosis
methotrexate
Pneumonia
Pneumonia - chemically induced
Pneumonia - complications
Pneumonia - diagnosis
Pneumonitis
Respiration
Rheumatoid arthritis
Risk factors
Tomography, X-Ray Computed
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:An 81-year-old woman with rheumatoid arthritis (RA) who had been treated with bucillamine presented with dyspnea. Computed tomography of the chest showed ground-glass opacities and consolidations in both lungs and honeycombing in both basal lung areas. An elevation of the serum Krebs von den Lungen-6 level and hypoxemia were seen. Lymphocytosis with a decreased CD4/CD8 ratio was seen in the bronchoalveolar lavage fluid. A transbronchial lung biopsy specimen showed organizing pneumonia. Based on a diagnosis of bucillamine-induced pneumonitis (BIP) with RA-associated pre-existing interstitial pneumonia, she was successfully treated with the cessation of bucillamine and systemic corticosteroid therapy. The risk factors and prognosis of BIP are discussed.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.2515-18