Bronchiolar disease associated with gold compounds administration in a patient with rheumatoid arthritis

Abstract

We report the case of a female patient with rheumatoid arthritis (RA) treated with gold sodium thiomalate and auranofin who developed bronchopulmonary involvement. Chest X-ray films showed diffuse mottled infiltrates and bronchial wall thickness in both lungs. Computed tomography revealed opacities along the thickening of the bronchovascular bundles. The pathologic findings were indistinguishable from those of diffuse panbronchiolitis. After discontinuation of gold compounds and initiation of steroid administration, her subjective symptoms immediately subsided. We conclude that our patient, who had suffered from chronic sinusitis and had a predisposition to bronchiolar disease, had bronchiolar disease induced by gold compounds.

Key words::

• Bronchiolar disease
• Diffuse panbronchiolitis
• Disease-modifying antirheumatic drugs (DMARDs)
• DMARDs-induced pulmonary injury
• Gold compounds
• Rheumatoid arthritis (RA)