A case of steroid-responsive organizing pneumonia in a patient with rheumatoid arthritis showing migratory inhltration and normal glucose levels in pleural effusions

A 59-year-old Japanese man with RA was referred to us with arthralgia and pulmonary infiltration. Chest roentgenogram showed migratory infiltration and pleural effusion, the glucose levels of the pleural fluid were not reduced. Transbronchial lung biopsy showed granulation tissue plugging the alveolar ducts, indicating organizing pneumonia and interstitial inflammation. These pathological findings were identical with those for cryptogenic organizing pneumonitis (COP). There was a good clinical and roentgenographic response and the pleural effusion responded well to corticosteroids. The characteristic migratory infiltration in rheumatoid lung disease responds well to corticosteroids.