Clinical case of differential diagnosis of lung cavities in rheumatoid arthritis
E. A. Zurilin,
N. A. Nikolaeva,
O. O. Voronkova,
L. M. Musaeva,
E. A. Kogan,
E. F. Rogova,
I. V. Menshikova,
M. V. Kozhevnikova,
Yu. N. Belenkov https://doi.org/10.18093/0869-0189-2025-35-4-597-602
Abstract
Rheumatoid arthritis (RA) is a disease that, in addition to affecting joints, is characterized by systemic damage to various localizations, including the lungs. Damage to the respiratory system occurs in about 30 – 40% of cases and may manifest in various ways, necessitating differential diagnosis. One of the manifestations is rheumatoid nodules, which can lead to the formation of cavities in the lungs, hemoptysis, and pneumothorax.
The aim of the work was to demonstrate a clinical case of a long-term follow-up of a patient with lung damage due to rheumatoid arthritis.
Conclusion. The article presents a clinical case of a patient with seropositive RA, who developed lung cavities accompanied by hemoptysis against the background of a prolonged course of the disease. Other causes, such as pulmonary embolism, malignant neoplasms, specific infection, and other systemic diseases, were excluded. Lung damage due to taking a drug from the TNF-alpha inhibitor group (Etanercept) was also considered; however, this option seemed unlikely due to the appearance of new foci after the drug withdrawal. An important step in making a diagnosis in this case was histological examination. The studied material contains signs of pulmonary vasculitis and rheumatoid nodules. Thus, visceral lung damage in RA was verified. This clinical observation demonstrates the need for differential diagnosis of lung cavities in RA with infectious,
About the Authors
E. A. Zurilin
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Evgeny A. Zurilin, Resident Physician, Department of Hospital Therapy No.1, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991
N. A. Nikolaeva
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Nadezhda A. Nikolaeva, Postgraduate Student, Department of Hospital Therapy No.1, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991
O. O. Voronkova
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Olga O. Voronkova, Candidate of Medicine, Assistant, Department of Hospital Therapy No.1, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991
L. M. Musaeva
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Larisa M. Musaeva, Postgraduate Student, Department of Hospital Therapy No.1, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991
E. A. Kogan
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Evgeniya A. Kogan, Doctor of Medicine, Professor, Institute of clinical Morphology and Digital Pathology
ul. Trubetskaya 8, build. 2, Moscow, 119991
E. F. Rogova
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Elena F. Rogova, Pulmonologist, Head of the Pulmonology Department, Hospital Therapy Clinic of the University Clinical Hospital No.1
ul. Trubetskaya 8, build. 2, Moscow, 119991
I. V. Menshikova
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Irina V. Menshikova, Doctor of Medicine, Professor, Department of Hospital Therapy No.1, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991
M. V. Kozhevnikova
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Maria V. Kozhevnikova, Candidate of Medicine, Professor, Department of Hospital Therapy No.1, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991
Yu. N. Belenkov
Федеральное государственное автономное образовательное учреждение высшего образования Первый Московский государственный медицинский университет имени И.М.Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)
Russian Federation
Russian Federation
Yuri N. Belenkov, Doctor of Medicine, Professor, Academician of the Russian Academy of Sciences, Head of the Department of Hospital Therapy No.1, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991
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For citations:
Zurilin E.A., Nikolaeva N.A., Voronkova O.O., Musaeva L.M., Kogan E.A., Rogova E.F., Menshikova I.V., Kozhevnikova M.V., Belenkov Yu.N. Clinical case of differential diagnosis of lung cavities in rheumatoid arthritis. PULMONOLOGIYA. 2025;35(4):597-602. (In Russ.) https://doi.org/10.18093/0869-0189-2025-35-4-597-602
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