Rheumatic pneumonitis

Goldring, David; Mr, Behrer; Brown, George; Elliott, Greg

doi:10.1016/s0022-3476(58)80145-6

Cited by 14 publications

(1 citation statement)

References 6 publications

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“…In our patient, an elevated ANA initially, along with a history of oral ulcers, hemoptysis, and proteinuria, complicated diagnosis, but lupus and a vasculitis workup were otherwise negative and rapid improvement of diffuse symptomatic carditis and resolution of pulmonary findings were more consistent with ARF. Autopsy reports in earlier series have shown interstitial infiltrates, alveolar hemorrhage, and other inflammatory changes as were seen on CT chest in this report [16][17]. Close multispecialty observation over 18 months has not yielded a different diagnosis, and follow-up rheumatologic testing was negative.…”

Section: Discussionsupporting

confidence: 62%

Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review

Kenney

McMullin

Abdul-Aziz

2020

Cureus

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Rheumatic pneumonia is a pulmonary complication of rheumatic fever, often with grave outcomes. It has been described sporadically in literature, most recently a decade ago. Here, we describe a case of a 12-year-old Native American girl presenting with chest pain, gastrointestinal complaints, and frequent nosebleeds. After the initial diagnosis with acute pericarditis, she was found to meet diagnostic criteria for rheumatic fever. Revised Jones criteria met included significantly elevated streptolysin O antibody and anti-DNase B, carditis, arthralgia, fever, and elevated inflammatory markers. Findings complicating the diagnosis were an elevated antinuclear antigen with a family history of systemic lupus erythematosus (SLE), hemoptysis, and a chest CT finding of right lower lobe alveolar hemorrhage as well as rightsided mediastinal adenopathy. The patient was discharged on day nine of admission after a course of high-dose methylprednisolone with prednisone taper, furosemide, enalapril, naproxen, monthly penicillin G injections, and multidisciplinary outpatient follow-up. A repeat chest CT scan three months later showed significant improvement. The pulmonary findings described in our patient are consistent with prior reports of rheumatic pneumonia, however, most prior cases described did not include high-resolution imaging. Our patient recovered well aside from complications secondary to mitral regurgitation, unlike many patients seen in our literature search who died due to early or later complications of pulmonary disease. Although acute rheumatic fever, and its pulmonary complications, is significantly less common than it once was, it remains a disease entity that should remain on the differential for multisystem rheumatic complaints.

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Section: Discussionsupporting

confidence: 62%