| Abstract | A 51-year-old man had been treated at a nearby hospital since 1993 for rheumatoid arthritis. Right pectoralgia developed in December 1994, and the patient consulted a nearby hospital, which detected right pleural effusion retention was pointed out on chest x-ray films. The patient was referred and admitted to our hospital. Rheumatic pleurisy was suspected because of a high serum rheumatoid factor(RF)level and high RF and high rheumatoid arthritis hemagglutination levels in the pleural effusion. However, due to a high adenosine deaminase level in the pleural effusion tuberculous pleurisy could not be ruled out. After drainage through a trocar catheter, the thoracic cavity was examined by thoracoscopy through the site of catheter insertion. As a result, sporadic bluish white nodular lesions were observed on the pleura. Granuloma formations presenting a palisade arrangement of giant cells were also observed, and pathologically diagnosed as rheumatoid nodules, thus providing the basis for a diagnosis of rheumatic pleurisy. Treatment with an increased dose of prednisolone achieved a rapid remission of the pleural effusion. Our experience underscored the usefulness of thoracoscopy as a means diagnosing of rheumatic pleurisy. |
| Authors | K Kimura, K Toyama, M Yoshida, T Hojyo, H Ryo, M Nakata, J Sim
(Affiliation: First Department of Internal Medicine, School of Medicine, Toho University, Tokyo, Japan.)
|
| Journal | Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
(Nihon Kokyuki Gakkai Zasshi)
Vol. 36
Issue 11
Pg. 994-7
(Nov 1998)
ISSN: 1343-3490 JAPAN |
| PMID | 9916487
(Publication Type: Case Reports, English Abstract, Journal Article)
|
| Chemical References |
- Anti-Inflammatory Agents
- Prednisolone
|
| Topics |
- Anti-Inflammatory Agents
(administration & dosage)
- Arthritis, Rheumatoid
(complications)
- Biopsy
(methods)
- Bronchoscopy
- Fiber Optics
- Humans
- Male
- Middle Aged
- Pleura
(pathology)
- Pleurisy
(diagnosis, drug therapy)
- Prednisolone
(administration & dosage)
|
