This morning Dr. Parekh presented a fascinating case of subacute shortness of breath in a patient with longstanding rheumatoid arthritis (RA). Dr. Girod provided and excellent review of rheumatoid associated pulmonary diseases as summarized below:
The patient in question demonstrated evidence of bronchiolitis obliterans on imaging exacerbated by viral bronchitis. Among the autoimmune disorders, the frequency of bronchiolitis obliterans is the highest in patients with rheumatoid arthritis. For an excellent overview of this unique pathology please see the this NEJM Review.