クラリスロマイシンが有効と考えられた慢性関節リウマチに先行した閉塞性細気管支炎の１例

DOI PubMed 被引用文献6件 参考文献20件

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  • Bronchiolitis Obliterans Preceding Rheumatoid Arthritis: Effect of Clarithromycin.

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A 62-year-old man was referred to our department because of exertional dyspnea and a 6-year history of coughing and sputum production. He had never smoked, and had had an operation for chronic paranasal sinusitis. Coarse crackels and rhonchi were audible over both lower lung fields. The cold hemagglutinin titers were high, pulmonary-function tests showed airflow obstruction, and a sputum culture revealed Hemophilus influenzae. A chest X-ray film and a CT scan showed diffuse micronodular shadows in the centrilobular regions, mild ectasis of bronchioles mainly in the lower lung fields, and mild hyperinflation. A specimen of lung tissue was obtained by thoracoscopic biopsy, and histologic examination showed bronchiolitis obliterans, with bronchiolar narrowing or obliteration due to submucosal fibrosis and inflammation. Rheumatoid arthritis was diagnosed 14 months after the operation. The patient was treated with clarithromycin for 3 years. Respiratory symptoms were relieved and pulmonary function gradually improved.

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