DIFFUSE INTERSTITIAL PULMONARY AMYLOIDOSIS IN RHEUMATOID-ARTHRITIS

We describe a woman with seronegative rheumatoid arthritis (RA) who pr esented with diffuse septal pulmonary amyloidosis mimicking interstiti al rheumatoid lung disease. Her systemic amyloidosis was diagnosed by biopsy of the kidney, stomach mucosa, and salivary glands 28 years aft er the onset of RA. Diffuse interstitial pulmonary infiltrates had bee n noted since that diagnosis, but infiltrates had been considered due to rheumatoid lung. Results of pulmonary function tests, which reveale d restrictive changes and decreased diffusion capacity, were also comp atible with rheumatoid lung disease. Pulmonary amyloidosis was diagnos ed at autopsy. Pulmonary amyloidosis should be considered a cause of p ulmonary infiltrates in patients with longstanding RA.