Chest
Selected ReportsRheumatic Pneumonitis
Section snippets
CASE MATERIAL
Autopsy was performed on 24 patients with acute rheumatic fever at Billings Hospital between 1949 and 1970; in each, the clinical summaries, description of organs, and relevant histologic material were reviewed. An average of four histologic sections from the lung were available. The diagnosis was based on clinical impressions, but in every case, it was confirmed by definite laboratory data and morphologic findings.
The patients ranged in age from 3 to 25 years (mean, 12 years). Ten were male,
OBSERVATIONS
At the time of autopsy, the lungs were typically described as red or plum-colored, heavy, and edematous. No infarcts were identified, and there were no other consistent gross findings.
Alveolar hemorrhage was present in nearly all sections, and in the majority of cases, red cells filled 25 to 50 percent of the airways. Capillary engorgement and pigmented alveolar macrophages (heart failure cells) were nearly constant findings.
Bronchopneumonia was seen in 14 of the 24 cases, and its histologic
COMMENT
The findings in the present study are in general agreement with those in the most recent large retrospective series reviewed by Scott et al7 and differ from the majority of previous descriptions because of the infrequent acute vascular changes.
Acute and organizing pneumonia was found in over half of the specimens, and two-thirds had evidence of an organizing fibrin-rich alveolar exudate similar to the pattern described by Heard et al8 in patients with chronic fibrinous pulmonary edema. The
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Cited by (11)
Pulmonary Involvement in Rheumatoid Disorders of Childhood
2006, Kendig's Disorders of the Respiratory Tract in ChildrenJuvenile rheumatic disorders
1993, Bailliere's Clinical RheumatologyPathology of the lungs: Expert consult: Online and print
2011, Pathology of the Lungs: Expert Consult: Online and PrintPathology of the Lungs
2011, Pathology of the LungsCryptogenic organising pneumonia
2006, European Respiratory JournalRheumatic pneumonia [8]
2001, Annals of the Rheumatic Diseases
Supported by USPHS Training Grant GM0093-14
Supported by RCDA HE 19022