BRONCHIOLAR DISEASE - IN RHEUMATOID-ARTHRITIS

The pulmonary manifestations of rheumatoid arthritis (RA) include bron chiolar diseases such as follicular bronchiolitis (FB) and bronchiolit is obliterans (BO). In this study, we investigated the clinical and pa thologic features of FB and BO, as well as the effect of erythromycin (EM) on these diseases. The subjects included 15 RA patients with biop sy-proven bronchiolar disease (eight with FB, seven with BO). None of the patients had Sjogren's syndrome. Eleven patients (73%) had chronic sinusitis, and 14 (93%) had a chronic cough with sputum. Bacterial cu lture of sputum was positive in 50% and 71% of the FB and BO patients, respectively. High-resolution computed tomography (HRCT) revealed sma ll nodular shadows in the centrilobular regions (FB and BO), patchy ar eas of low attenuation (BO), and peribronchial thickening (FB and BO). Eleven patients who received EM therapy showed a significant improvem ent of symptoms. In addition, none of the 15 patients died of the bron chiolar disease during follow-up. In conclusion, RA patients with FB o r BO basically have a chronic clinical course with main complaint of p roductive cough, and EM may be useful for the management of these dise ases.