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Bilateral spontaneous pneumothorax in a patient with pulmonary rheumatoid nodules, secondary infected by Aspergillus

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Abstract

This case report describes a 50-year-old woman with rheumatoid arthritis (RA) in whom nodular opacities were found on chest X-ray. She developed a bilateral spontaneous pneumothorax treated with surgical pleurodesis. Cultures remained negative. Histological examination of specimens confirmed the clinical diagnosis of rheumatoid granulomata. Therefore, corticosteroid therapy was started, after which the nodules decreased slightly in size and inflammatory parameters normalized. Three months later, she presented with respiratory insufficiency based on pulmonary fungus infection. Differential diagnosis between rheumatoid nodules and granulomas caused by Aspergillus is difficult in RA patients with pulmonary nodular lesions; in this case, both complications appeared subsequently.

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Authors and Affiliations

  1. Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Linsey Winne, Eric Veys & Herman Mielants

  2. Department of Pathology, Ghent University Hospital, Ghent, Belgium

    Marleen Praet

  3. Department of Pneumology, Ghent University Hospital, Ghent, Belgium

    Guy Brusselle

Authors
  1. Linsey Winne
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  2. Marleen Praet
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  3. Guy Brusselle
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  4. Eric Veys
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  5. Herman Mielants
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Corresponding author

Correspondence to Herman Mielants.

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Winne, L., Praet, M., Brusselle, G. et al. Bilateral spontaneous pneumothorax in a patient with pulmonary rheumatoid nodules, secondary infected by Aspergillus . Clin Rheumatol 26, 1180–1182 (2007). https://doi.org/10.1007/s10067-006-0319-x

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  • DOI: https://doi.org/10.1007/s10067-006-0319-x

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