Rheumatology 2018;0:1 Clinical Vignette doi:10.1093/rheumatology/key114 Lung involvement in polymyalgia rheumatica Funding: No specific funding was received from any bodies in the public, commercial or not-for-profit sectors A 72-year-old man presented with a 4-week history of to carry out the work described in this manuscript. coughing and pain in the shoulders and hips, with morning stiffness. Physical examination revealed a limited range of motion of the shoulder and hip joints owing to pain. The Disclosure statement: The author has declared no conflict temporal arteries were neither tender nor pulseless. of interest. Serum ESR was high. A chest radiograph showed an in- Takeshi Kondo filtrate in the left upper lobe and nodular opacities in the right middle and lower lobes (Fig. 1A). PET/CT Department of General Medicine, Chiba University Hospital, demonstrated accumulation of fluorodeoxyglucose in the Chiba, Japan FIG.1 Chest radiograph and PET/CT (A) Chest radiograph showing an infiltrate in the left upper lobe and nodular opacities in the right middle and lower lobes. (BE) PET/CT showing accumulation of fluorodeoxyglucose in the shoulder joints, lateral sides of the greater trochanters, the right ischial tuberosity and the lung lesions. Correspondence to: Takeshi Kondo, Department of General shoulder joints, lateral sides of the greater trochanters, the Medicine, Chiba University Hospital, 1-8-1, Inohana, Chuo- right ischial tuberosity and the lung lesions (Fig. 1BE). ku, Chiba City, Chiba 260-8677, Japan. Large vessels were not affected. Transbronchial lung E-mail: email@example.com biopsy identified organizing pneumonia. A diagnosis of organizing pneumonia associated with PMR was made. His symptoms and chest radiological abnormalities resolved after treatment with oral prednisolone. Interstitial lung diseases, which are histopathologically References classified into usual interstitial pneumonia, non-specific interstitial pneumonia, organizing pneumonia with diffuse 1 Gutsche M, Rosen GD, Swigris JJ. Connective tissue disease-associated interstitial lung disease: a review. Curr alveolar damage, and lymphocytic interstitial pneumonia, Respir Care Rep 2012;1:22432. are encountered in patients with various CTDs . Although lung involvement is very rare in PMR, temporal 2 Stey C, Truninger K, Marti D, Vogt P, Medici TC. arteritis and GCA, organizing pneumonia can be a lung Bronchiolitis obliterans organizing pneumonia associated manifestation of PMR . with polymyalgia rheumatica. Eur Respir J 1999;13:9269. The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: firstname.lastname@example.org Downloaded from https://academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/key114/4970492 by Ed 'DeepDyve' Gillespie user on 12 July 2018
Rheumatology – Oxford University Press
Published: Apr 13, 2018
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