ORIGINAL RESEARCH PAPER; Medical Science

PARIPEX - INDIAN JOURNAL OF RESEARCH VOLUME-6 | ISSUE-7 | JULY-2017 | ISSN - 2250-1991 | IF : 5.761 | IC Value : 79.96

Case report

Endogenous lipoid pneumonia associated with rheumatoid arthritis, Tuberculosis and cytomegalovirus infection

Hamidreza Jamaati¹ (Associate Professor of Internal Medicine and Critical Care), Shahram Kahkouee² (Assistant Professor of Radiology), Mohsen Farrokhpour³* (Assistant of pulmonary department), Mitra Rezaei⁴ (Assistant. Professor in Lung specialty), Fatemeh Mir-Aboutalebi³ (Assistant in Lung specialty), Kimia Taghavi³ (Assistant of biology department)

1-Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

2-Department of Radiology, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

3-Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

4-Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

*Correspondence to: Mohsen Farrokhpour

Address: Chronic Respiratory Disease Research Center, Massih Daneshvari Hospital, Shaheed Bahonar Ave, Tehran 1956944413, Iran

Email address: mohsenfrkh@gmail.com

Endogenous lipoid pneumonia associated with rheumatoid arthritis, Tuberculosis and cytomegalovirus infection

Abstract

Background: Lipoid pneumonia is a rare disease with presence of lipids in the alveoli from endogenous or exogenous sources. Endogenous Lipoid pneumonia complicated with Rheumatoid arthritis, Cytomegalovirus and Tuberculosis has seldom been documented. Current case of uncommon complicated endogenous lipoid pneumonia adds observational data to previous knowledge about the causes of the disease.

Case Presentation: A woman aged 37 years with eight years of involvement with rheumatoid arthritis developed progressive pleural effusion and semi-turbid exudative lymph dominant fluid. Patient had positive Broncho alveolar lavage fluid for cytomegalovirus and Mycobacterium tuberculosis. Histology of a transbronchial lung biopsy revealed interstitial inflammation and intra alveolar fibrosis associated with lipoid pneumonia. A significantly improvement was achieved by parallel administration of Valgancyclovir, anti TB therapy and steroid therapy by prednisolone.

Conclusions: Rare pathogenesis causes of endogenous lipoid pneumonia in the cases such as described case here, should be better recognized by clinicians to prevent the development of endogenous lipoid pneumonia. The findings highlight that in RA patients suspicious to lipoid pneumonia, RA treatment shift to Adalimumab in combination with MTX, is a fundamental plan.

Keywords:Cholesterol, Pneumonia, Arthritis Rheumatoid, Mycobacterium tuberculosis, Cytomegalovirus, Tuberculosis, Lipoid pneumonia

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