Endogenous lipoid pneumonia associated with rheumatoid arthritis, Tuberculosis and cytomegalovirus infection
Journal Title: PARIPEX-Indian Journal of Research - Year 2017, Vol 6, Issue 7
Abstract
Background: Lipoid pneumonia is a rare disease with presence of lipids in the alveoli from endogenous or exogenous sources. Endogenous Lipoid pneumonia complicated with Rheumatoid arthritis, Cytomegalovirus and Tuberculosis has seldom been documented. Current case of uncommon complicated endogenous lipoid pneumonia adds observational data to previous knowledge about the causes of the disease. Case Presentation: A woman aged 37 years with eight years of involvement with rheumatoid arthritis developed progressive pleural effusion and semi-turbid exudative lymph dominant fluid. Patient had positive Broncho alveolar lavage fluid for cytomegalovirus and Mycobacterium tuberculosis. Histology of a transbronchial lung biopsy revealed interstitial inflammation and intra alveolar fibrosis associated with lipoid pneumonia. A significantly improvement was achieved by parallel administration of Valgancyclovir, anti TB therapy and steroid therapy by prednisolone. Conclusions: Rare pathogenesis causes of endogenous lipoid pneumonia in the cases such as described case here, should be better recognized by clinicians to prevent the development of endogenous lipoid pneumonia. The findings highlight that in RA patients suspicious to lipoid pneumonia, RA treatment shift to Adalimumab in combination with MTX, is a fundamental plan.
Authors and Affiliations
Hamidreza Jamaati, Shahram Kahkouee, Mohsen Farrokhpour, Mitra Rezaei, Fatemeh Mir- Aboutalebi, Kimia Taghavi
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