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Pulmonary and Critical Care Pearls |

A 24-Year-Old Woman With Bilateral Pulmonary Infiltrates, Pericardial Effusion, and Bilateral Pleural Effusions*

Chandra K. Katikireddy, MD; Ganesh Krishna, MD; Gerald Berry, MD; John Faul, MD; Ware Kuschner, MD
Author and Funding Information

*From the Division of Pulmonary and Critical Care Medicine (Drs. Katikireddy and Faul), Stanford University Hospital; Division of Pulmonary Medicine (Drs. Krishna and Kuschner), VA Palo Alto Health Care System; and Division of Pathology (Dr. Berry), Stanford University Hospital, Palo Alto, CA.

Correspondence to: Ware Kuschner, MD, Division of Pulmonary Medicine, 3801 Miranda Ave, Palo Alto, CA 94304-1290; email: kuschner@leland.stanford.edu



Chest. 2005;128(6):4013-4017. doi:10.1378/chest.128.6.4013
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A 24-year-old woman presented with a 3-week history of exertional dyspnea and dry cough. Her medical history was remarkable for rheumatoid arthritis (RA). She had no exacerbation of joint symptoms during the prior 2 years. She denied fever or other constitutional symptoms. She took ibuprofen occasionally but no other antirheumatic medications. She was a lifelong nonsmoker. Her review of systems, family, social, and exposure histories were noncontributory.

1Anaya, JM, Diethelm, L, Ortiz, LA, et al (1995) Pulmonary involvement in rheumatoid arthritis.Semin Arthritis Rheum24,242-2542Bartter, T, Irwin, RS, Nosh, G, et al Idiopathic bronchiolitis obliterans organizing pneumonia with peripheral infiltrates on chest roentgenogram.Arch Intern Med1989;149,273-2793Cordier, JF Organizing pneumonia.Thorax2000;55,318-3284Cordier, JF Cryptogenic organizing pneumonia.Clin Chest Med2004;25,727-7385Dedhia, HV, DiBartolomeo, A Rheumatoid arthritis.Crit Care Clin2002;18,841-8526Epler, G Bronchiolitis obliterans organizing pneumonia: definition and clinical features.Chest1992;102(suppl),2S-6S7Ippolito, JA, Palmer, L, Spector, S, et al Bronchiolitis obliterans organizing pneumonia and rheumatoid arthritis.Semin Arthritis Rheum1993;23,70-788John, JT, Jr, Hough, A, Sergent, JS Pericardial disease in rheumatoid arthritis.Am J Med1979;66,385-3909Joseph, J, Sahn, SA Connective tissue diseases and the pleura.Chest1993;104,262-27010Lettieri, CJ, Veerappan, GR, Helman, DL, et al Outcomes and safety of surgical lung biopsy for interstitial lung disease.Chest2005;127,1600-160511Riley, DJ Risk of surgical lung biopsy in idiopathic interstitial pneumonias.Chest2005;127,1485-148612Shiel, WC, Prete, PE Pleuropulmonary manifestations of rheumatoid arthritis.Semin Arthritis Rheum1984;13,235-24313Tanoue, LT Pulmonary manifestations of rheumatoid arthritis.Clin Chest Med1998;19,66714Van Thiel, RJ, Van der Burg, S, Groote, AD, et al Bronchiolitis obliterans organizing pneumonia and rheumatoid arthritis.Eur Respir J1991;4,905-911

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