Referring to an unusual case: pulmonary affection and rheumatoid arthritis
Borges, H.; Schnyder, J.-M.; Frey, J.-G.; Tschopp, J.-M.
Revue Medicale Suisse 5(225): 2276-2280
2009
ISSN/ISBN: 1660-9379 PMID: 19999316 Document Number: 14583
We report the case of a 60 year female patient suffering from rheumatoid arthritis for the last 25 years, under TNF-blocker and leflunomide, affected by a recurrent pneumothorax with several subpleural nodules, basal bronchiectasis and apical bullous emphysema. The patient was administered several treatments: aspiration, talc pleurodesis, surgical pleurodesis, pleurodesis induced by tetracycline and autologous blood. To allow the pleural inflammatory reaction necessary to the success of the pleurodesis, we had to interrupt the treatment by TNF-blocker and leflunomide. We then witnessed a partial pleurodesis with persistence of a pneumothorax. The medical situation is improving with disappearance of dyspnea.
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