Pulmonology
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
CXR – round opacity/opacities >5 mm in diameter:1 Neoplasia (benign tumour; ca. lung; metastases).2 Infection (‘rounded’ pneumonia;3 lung abscess; TB granuloma; hydatid cyst; histoplasmosis).3 Rheumatoid nodule.4 Wegener’s granuloma.5 AVM.
Practice Paper 5: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
This woman has a classic history of rheumatoid arthritis. Because symptomatic therapy is not working, she will need additional treatment with a disease-modifying antirheumatic drug (DMARD). Examples of DMARDs are ciclosporin, sulfasalazine, methotrexate, azathioprine and hydroxychloroquine. The first-line DMARD used in the UK is sulfasalazine. This patient has a rheumatoid nodule, and should ideally not receive methotrexate (which causes accelerated nodule growth).
Inflammatory rheumatic disorders
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Rheumatoid nodules The rheumatoid nodule is a small granulomatous lesion consisting of a central necrotic zone surrounded by a radially disposed palisade of local histiocytes, and beyond that by inflammatory granulation tissue. Nodules occur under the skin (especially over bony prominences), in the synovium, on tendons, in the sclera and in many of the viscera.
Successful abatacept treatment for Felty’s syndrome in a patient with rheumatoid arthritis
Published in Modern Rheumatology Case Reports, 2020
A 69-year-old man was admitted to our hospital because of severe neutropenia. He was diagnosed with RA 38 years earlier and had been treated with etanercept (ETN) 50 mg/w and 8 mg/week methotrexate (MTX) for the past 5 years. He was suffered from febrile neutropenia 6 months ago He was discontinuation of ETN and MTX 3 months ago because neutropenia was developed. However, neutropenia was worsened to 260/μL, treatment of granulocyte colony-stimulating factor (G-CSF) was started 1 month ago with no effect on neutropenia. On admission, the temperature was 37.1 °C. He had a rheumatoid nodule on his left elbow. Lymph node swelling was not noted. Laboratory data showed leukopoenia (white blood cell: 1200/μL, neutrophil: 234/μL), positive for anti-CCP antibody (56.7 U/mL) was positive for rheumatoid factor (RF) (414.0 IU/mL), C-reactive protein levels was elevated (3.58 mg/dL). Anti-nuclear antibody, anti-SS-A antibody, anti-RNP antibody, anti-ds-DNA antibody were negative. Large granular lymphocytic were not detected. Liver enzyme levels and LDH were almost within normal limits. Chest X-ray revealed old inflammatory nodules. An X-ray showed bone erosion and joint destruction in metacarpophalangeal joints of the both hand. Abdominal ultrasonography revealed splenomegaly. Abdominal computed tomography (CT) showed splenomegaly without malignancy. The diagnosis of Felty’s syndrome was made. The 28-Joint Disease Activity Score (DAS)-CRP was 5.69. Following diagnosis, he received intravenous injection of 500 mg ABT every four weeks (Figure 1). His neutrophil counts returned to normal (1840/μL) after 6 months. DAC28-CRP was improved to 2.28. RF was decreased to 319.0 IU/mL. No severe adverse events occurred during the clinical course.
Renin–angiotensin system molecules are associated with subclinical atherosclerosis and disease activity in rheumatoid arthritis
Published in Modern Rheumatology, 2021
Nayara Felicidade Tomaz Braz, Maria Raquel C. Pinto, Érica Leandro Marciano Vieira, Adriano J. Souza, Antonio Lucio Teixeira, Ana C. Simões-e-Silva, Adriana Maria Kakehasi
The occurrence of extra-articular manifestations of RA at any time of the disease was investigated and included secondary Sjögren’s syndrome, rheumatoid nodule, constitutional symptoms (weight loss and fever, with no other apparent causes); pleural or pulmonary involvement, vasculitis, noncompressive neuropathy, scleritis/episcleritis, pericarditis and Felty’s syndrome.
When the plot thickens: a rare complication of rheumatoid arthritis
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Marianne Scheitel, Samuel T. Ives, Rawad Nasr, Marc W. Nolan
Extraarticular manifestations of rheumatoid arthritis affecting the central nervous system (CNS) are rare. The most well-known CNS involvement is C1-C2 atlantoaxial subluxation resulting in cervical myelopathy. Other rare manifestations include vasculitis, compressive rheumatoid nodule formation, and pachymeningitis [3].
Related Knowledge Centers
- Eyelid
- Histology
- Vulva
- Vertebral Column
- Larynx
- Gallbladder
- Rheumatoid Arthritis
- Rheumatoid Nodulosis
- Sole
- Heart Valve