A Case of Pulmonary Infarction Resembling Pneumonia during Immunosuppressive Treatment for Rheumatoid Arthritis.
Toshiki KidoKoichiro ShinodaKazuyuki TobePublished in: Case reports in rheumatology (2021)
A 67-year-old woman with rheumatoid arthritis (RA) presented with fever and dyspnea. Chest radiography and computed tomography (CT) revealed pulmonary infiltrates with ground-glass opacities. We considered bacterial or pneumocystis pneumonia because she was immunocompromised due to RA treatment. However, she had tachycardia and elevated D-dimer levels. We performed contrast-enhanced CT and subsequently diagnosed her with pulmonary embolism (PE). Though PE is not usually accompanied by parenchymal pulmonary shadows, pulmonary infarction may cause pulmonary infiltrates that can be mistaken for pneumonia. As RA is a thrombophilic disease, clinicians should be aware of PE and pneumonia as differential diagnoses in such patients.
Keyphrases
- rheumatoid arthritis
- contrast enhanced
- computed tomography
- pulmonary hypertension
- pulmonary embolism
- magnetic resonance imaging
- disease activity
- dual energy
- image quality
- diffusion weighted
- magnetic resonance
- ankylosing spondylitis
- positron emission tomography
- respiratory failure
- newly diagnosed
- interstitial lung disease
- diffusion weighted imaging
- ejection fraction
- intensive care unit
- prognostic factors
- community acquired pneumonia
- inferior vena cava
- single cell
- atrial fibrillation
- mechanical ventilation
- catheter ablation
- acute respiratory distress syndrome