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Pulmonary rheumatoid nodules (PRN) occur in 20%−25% of rheumatoid arthritis (RA) patients and can lead to complications.1 Disease-modifying antirheumatic drugs (leflunomide, methotrexate) and antitumour necrosis factor α (anti-TNFα) have been implicated in their development.2,–,4 The immunopathological characteristics of PRN are quite distinct from those of subcutaneous nodules with the presence of B lymphocytes expressing CD20 in the periphery.5 We therefore decided to assess the efficacy of rituximab (RTX) in patients with PRN using data from the French AutoImmunity and Rituximab/Rheumatoid Arthritis registry.6 Of the 10 patients studied, all but one (n 8) were positive for rheumatoid factors and anticitrullinated protein antibodies (anti-CCP). Five patients had a history of smoking: two were active smokers (n 2, 3), and three past smokers (n 5, 7, 9). All patients had previously received …
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