Lesson of the month
Recurrent lung shadowing in adult juvenile idiopathic arthritis
Tsui Liana, John Brittendenb, Stanley Pearsonb, Paul Emerya
a Rheumatology and
Rehabilitation Research Unit, University of Leeds, Leeds, b Respiratory Medicine Unit, Leeds
General Infirmary, Leeds
Correspondence to: Professor P Emery, Rheumatology and Rehabilitation Research Unit, University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ.
Accepted for publication 23 May 1999
| The first 150 words of the full text of this article appear below. |
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Case report |
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A 25 year old Asian woman with a 11 year history of juvenile idiopathic arthritis (polyarthritis, rheumatoid factor positive) was referred from a peripheral hospital with poor disease control despite multiple disease modifying anti-rheumatic drugs (DMARDS). She was not a cigarette smoker and had been taking azathioprine 125 mg daily and prednisolone 5 mg daily for the past 10 months. Her past medical history included pulmonary tuberculosis diagnosed 14 months ago for which she had completed six months of antituberculous treatment. Details of her previous respiratory management including radiographs were not available. Physical examination revealed generalised synovitis with normal respiratory findings. She was treated with intra-articular corticosteroid injections into multiple joints and sulfasalazine was added to her above medications. Sulfasalazine was increased to a dose of 2 g daily over a four week period.
One month later, she re-presented with about two weeks history of dry
cough and dyspnoea. Physical examination revealed that she was
apyrexial with
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