Bronchiolitis obliterans organizing pneumonia associated with sulfasalazine in a patient with rheumatoid arthritis

Ulubaş, Bahar; Şahin, Günşah; Özer, Caner; Aydın, Özlem; Özgür, Eylem Sercan; Apaydin, Demir

doi:10.1007/s10067-003-0848-5

Cited by 29 publications

(5 citation statements)

References 3 publications

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“…Of note, sulfasalazine has been associated with hypersensitivity pneumonitis, with nearly half of the patients presented with pulmonary infiltrates and eosinophilia; clinical improvements usually occur following drug discontinuation, yet progressing respiratory failure and the cases of death have also been described (84,85). Respiratory manifestations associated with sulfasalazine include NSIP, OP, granulomatous disease, bronchiolitis obliterans, and pleural effusion (86,87). Leflunomide has also been variably associated with rapid-onset hypersensitivity pneumonitis and a new onset or the progression of pre-existing ILD (87,88).…”

Section: Mtx and Common Dmardsmentioning

confidence: 99%

Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review

Laria¹,

Lurati²,

Zizzo³

et al. 2022

Front. Med.

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Rheumatoid arthritis (RA) is a systemic inflammatory disease, which primarily causes symmetric polyarthritis. An extrarticolar involvement is common, and the commonly involved organ is lungs. Although cardiac disease is responsible for most RA-related deaths, pulmonary disease is also a major contributor, accounting for ~10–20% of all mortality. Pulmonary disease is a common (60–80% of patients with RA) extra-articular complication of RA. Optimal screening, diagnostic, and treatment strategies of pulmonary disease remain uncertain, which have been the focus of an ongoing investigation. Clinicians should regularly assess patients with RA for the signs and symptoms of pulmonary disease and, reciprocally, consider RA and other connective tissue diseases when evaluating a patient with pulmonary disease of an unknown etiology. RA directly affects all anatomic compartments of the thorax, including the lung parenchyma, large and small airways, pleura, and less commonly vessels. In addition, pulmonary infection and drug-induced lung disease associated with immunosuppressive agents used for the treatment of RA may occur.

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Section: Mtx and Common Dmardsmentioning

confidence: 99%

Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review

Laria¹,

Lurati²,

Zizzo³

et al. 2022

Front. Med.

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“…Poorly formed non-necrotizing granulomas may be found in the lung biopsy [ 101 ]. The OP is another possible, albeit less frequent, pathological pattern [ 107 ]. Acute phase reaction and peripheral blood eosinophilia may be present [ 99 , 104 , 106 , 108 ].…”

Section: Drug-related Lung Pathology In Inflammatory Bowel Disease Pamentioning

confidence: 99%

Pulmonary manifestations of inflammatory bowel disease

Majewski¹,

Piotrowski²

2015

aoms

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Bronchopulmonary signs and symptoms are examples of variable extraintestinal manifestations of the inflammatory bowel diseases (IBD). These complications of Crohn's disease (CD) and ulcerative colitis (UC) seem to be underrecognized by both pulmonary physicians and gastroenterologists. The objective of the present review was to gather and summarize information on this particular matter, on the basis of available up-to-date literature. Tracheobronchial involvement is the most prevalent respiratory presentation, whereas IBD-related interstitial lung disease is less frequent. Latent and asymptomatic pulmonary involvement is not unusual. Differential diagnosis should always consider infections (mainly tuberculosis) and drug-induced lung pathology. The common link between intestinal disease and lung pathology is unknown, but many hypotheses have been proposed. It is speculated that environmental pollution, common immunological mechanisms and predisposing genetic factors may play a role.

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“…Synthetic DMARDs, such as gold salts, MTX, penicillamine, sulfasalazine, and cyclophosphamide, have been reported to cause iatrogenic OP. 15 , 65 , 66 There are several cases of DMARD-related OP in the literature, in which RA patients were under treatment with leflunomide, 67 bucillamine (an analog of d -penicillamine), 68 – 71 sulfasalazine, 72 and MTX. 73 But a direct relationship between drug administration and OP development was not completely established in these cases.…”

Section: Dmard-related Opmentioning

confidence: 99%

Organizing Pneumonia in Rheumatoid Arthritis Patients: A Case-Based Review

Mori¹,

Koga²,

Sugimoto

2015

Clin Med Insights Circ Respir Pulm Med

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We treated 21 patients with organizing pneumonia (OP) associated with rheumatoid arthritis (RA) or related to biological disease-modifying antirheumatic drugs (DMARDs) at our institution between 2006 and 2014. Among these cases, 3 (14.3%) preceded articular symptoms of RA, 4 (19.0%) developed simultaneously with RA onset, and 14 (66.7%) occurred during follow-up periods for RA. In the case of OP preceding RA, increased levels of anti-cyclic citrullinated peptide antibodies and rheumatoid factor were observed at the OP onset. RA disease activity was related to the development of OP in the simultaneous cases. In the cases of OP developing after RA diagnosis, 10 of 14 patients had maintained low disease activity with biological DMARD therapy at the OP onset, and among them, 6 patients developed OP within the first year of this therapy. In the remaining four patients, RA activity was not controlled at the OP onset. All patients responded well to systemic steroid therapy, but two patients suffered from relapses of articular and pulmonary symptoms upon steroid tapering. In most of the RA patients, DMARD therapy was introduced or restarted during the steroid tapering. We successfully restarted a biological DMARD that had not been previously used for patients whose RA would otherwise have been difficult to control. In this study, we also perform a review of the literature on RA-associated or biological DMARD-related OP and discuss the pathogenesis and management of OP occurring in RA patients.

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Bronchiolitis obliterans organizing pneumonia associated with sulfasalazine in a patient with rheumatoid arthritis

Cited by 29 publications

References 3 publications

Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review

Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review

Pulmonary manifestations of inflammatory bowel disease

Organizing Pneumonia in Rheumatoid Arthritis Patients: A Case-Based Review

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