1
|
Bektyrganova S, Kozhakhmet D, Kim A, Baigenzhin A, Togizbayev G, Doszhan A, Krivoruchkо N, Pak A, Peradze M, Sarsengaliyev T. A case report of extra-articular manifestation of rheumatoid arthritis: Rheumatoid nodules in lungs. Int J Rheum Dis 2024; 27:e14904. [PMID: 37784218 DOI: 10.1111/1756-185x.14904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/29/2023] [Accepted: 08/22/2023] [Indexed: 10/04/2023]
Abstract
Rheumatoid arthritis is a systemic inflammatory disorder primarily affecting joints but not limited to the joints alone. Extra-articular manifestations involve skin, ocular, gastrointestinal, pulmonary, cardiac, renal, neurological, and hematological systems. Among them, skin manifestations (20%) are most common, presenting as nodules on the extensor surfaces of the upper and lower extremities. In rare cases these nodules can also be detected within the heart and lungs. Interestingly, rheumatoid nodules are often seen in patients on leflunomide, methotrexate, or tumor necrosis factor-alpha antagonists. Nevertheless, definitive diagnosis requires a histopathological analysis. In this case report, we presented a 49-year-old male patient with a relatively short period of disease activity leading to rheumatoid nodules in the lungs. Considering the ongoing COVID-19 pandemic and that tuberculosis was still endemic in Kazakhstan, achieving the definite diagnosis was challenging. Initial imaging study revealed bilateral polysegmental pneumonia. The tests for COVID-19 and pulmonary tuberculosis were negative. A follow-up chest computed tomography scan had signs of disseminated lung lesions of unknown origin. Lung biopsy showed a morphological picture of productive granulomas characteristic for tuberculosis. However, at the second look, typical scarring granulomas typically seen in rheumatoid nodules were observed.
Collapse
Affiliation(s)
- Saltanat Bektyrganova
- Department of Internal Medicine, JSC National Scientific Medical Center, Astana, Kazakhstan
- Astana Medical University, Astana, Kazakhstan
| | | | - Alexey Kim
- Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Abay Baigenzhin
- JSC National Scientific Medical Center, Chairman of the Board, Astana, Kazakhstan
| | - Galymzhan Togizbayev
- Department of Rheumatology, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
- Ministry of Health of the Republic of Kazakhstan, Qazaq College of Rheumatology, Astana, Kazakhstan
| | - Ainur Doszhan
- Department of Internal Medicine, JSC National Scientific Medical Center, Astana, Kazakhstan
| | - Natalya Krivoruchkо
- Department of Internal Medicine, JSC National Scientific Medical Center, Astana, Kazakhstan
| | - Alexey Pak
- Department of Internal Medicine, JSC National Scientific Medical Center, Astana, Kazakhstan
| | - Manana Peradze
- Department of Pathology, JSC National Scientific Medical Center, Astana, Kazakhstan
| | - Timur Sarsengaliyev
- Department of Radiology, JSC National Scientific Medical Center, Astana, Kazakhstan
| |
Collapse
|
2
|
Fukuda Y, Tsugawa T, Nagaoka Y, Ishii A, Nawa T, Togashi A, Kunizaki J, Hirakawa S, Iida J, Tanaka T, Kizawa T, Yamamoto D, Takeuchi R, Sakai Y, Kikuchi M, Nagai K, Asakura H, Tanaka R, Yoshida M, Hamada R, Kawasaki Y. Surveillance in hospitalized children with infectious diseases in Japan: Pre- and post-coronavirus disease 2019. J Infect Chemother 2021; 27:1639-1647. [PMID: 34389224 PMCID: PMC8332734 DOI: 10.1016/j.jiac.2021.07.024] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/27/2021] [Accepted: 07/31/2021] [Indexed: 01/14/2023]
Abstract
Introduction The epidemic of coronavirus disease 2019 (COVID-19) rapidly spread worldwide, and the various infection control measures have a significant influence on the spread of many infectious diseases. However, there have been no multicenter studies on how the number of hospitalized children with various infectious diseases changed before and after the outbreak of COVID-19 in Japan. Methods We conducted a multicenter, prospective survey for hospitalized pediatric patients in 18 hospitals in Hokkaido Prefecture, Japan, from July 2019 to February 2021. We defined July 2019 to February 2020 as pre-COVID-19, and July 2020 to February 2021 as post-COVID-19. We surveyed various infectious diseases by sex and age. Results In total, 5300 patients were hospitalized during the study period. The number of patients decreased from 4266 in the pre-COVID-19 period to 701 (16.4%) post-COVID-19. Patients with influenza and RSV decreased from 308 to 795 pre-COVID-19 to zero and three (0.4%) post-COVID-19. However, patients with adenovirus (respiratory infection) only decreased to 60.9% (46–28) of pre-COVID levels. Patients with rotavirus, norovirus, and adenovirus gastroenteritis decreased markedly post-COVID-19 to 2.6% (38–1), 27.8% (97–27) and 13.5% (37–5). The number of patients with UTIs was similar across the two periods (109 and 90). KD patients decreased to 31.7% (161–51) post-COVID-19. Conclusions We suggest that current infection control measures for COVID-19 such as wearing masks, washing hands, and disinfecting hands with alcohol are effective against various infectious diseases. However, these effects vary by disease.
Collapse
Affiliation(s)
- Yuya Fukuda
- Department of Pediatrics, Steel Memorial Muroran Hospital, 45-1, Chiribetsucho, Muroran, Hokkaido, 050-0076, Japan.
| | - Takeshi Tsugawa
- Department of Pediatrics, Sapporo Medical University School of Medicine, South-1, West-16 Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
| | - Yoshinobu Nagaoka
- Department of Pediatrics, Sapporo Medical University School of Medicine, South-1, West-16 Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Akira Ishii
- Department of Pediatrics, Sapporo Medical University School of Medicine, South-1, West-16 Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Tomohiro Nawa
- Department of Pediatric Cardiology and Pediatric Intensive Care, Hokkaido Medical Center for Child Health and Rehabilitation, 6-240-1-1, Kanayama Teine-ku, Sapporo, Hokkaido, 006-0041, Japan
| | - Atsuo Togashi
- Department of Pediatrics, Iwamizawa Municipal General Hospital, 2 West-7, 9-Jo, Iwamizawa, Hokkaido, 068-8555, Japan
| | - Jun Kunizaki
- Department of Pediatrics, Japan Red Cross Urakawa Hospital, 1-2-1, Chinomi, Higashimachi, Urakawagun Urakawacho, Hokkaido, 057-0007, Japan
| | - Satoshi Hirakawa
- Department of Pediatrics, NTT Medical Center Sapporo, South-1, West-15, Sapporo, Hokkaido, 060-0061, Japan
| | - Junya Iida
- Department of Pediatrics, Otaru Kyokai Hospital, 15-6-1, Suminoe, Otaru, Hokkaido, 047-8510, Japan
| | - Toju Tanaka
- Department of Pediatrics, Hokkaido Medical Center, 1-1-7-5, Yamanote, Nishi-ku, Sapporo, Hokkaido, 063-0005, Japan
| | - Toshitaka Kizawa
- Department of Pediatrics, Japan Community Health Care Organization Sapporo Hokushin Hospital, 1-2-6-2, Atsubetsuchuo, Atsubetsu-ku, Sapporo, Hokkaido, 004-8618, Japan
| | - Dai Yamamoto
- Department of Pediatrics, Kushiro City General Hospital, 12-1, Shunkodai, Kushiro, Hokkaido, 085-0822, Japan
| | - Ryoh Takeuchi
- Department of Pediatrics, Nemuro City Hospital, 2-1, Ariisocho, Nemuro, Hokkaido, 087-8686, Japan
| | - Yoshiyuki Sakai
- Department of Pediatrics, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate, Hokkaido, 041-8680, Japan
| | - Masayoshi Kikuchi
- Department of Pediatrics, Sunagawa City Medical Center, 1-1, North-3, West-4, Sunagawa, Hokkaido, 073-0196, Japan
| | - Kazushige Nagai
- Department of Pediatrics, Takikawa Municipal Hospital, 34-2-2, Oomachi, Takikawa, Hokkaido, 073-0022, Japan
| | - Hirofumi Asakura
- Department of Pediatrics, Hokkaido Esashi Hospital, 484, Fushikidocho, Hiyamagun Esashicho, Hokkaido, 043-0022, Japan
| | - Rina Tanaka
- Department of Pediatrics, Tomakomai City Hospital, 20-5-1, Shimizucho, Tomakomai, Hokkaido, 053-8567, Japan
| | - Masaki Yoshida
- Department of Pediatrics, Yakumo General Hospital, 50, Shinonomecho, Futamigun Yakumocho, Hokkaido, 049-3197, Japan
| | - Ryo Hamada
- Department of Pediatrics, Rumoi City Hospital, 1-16-2, Shinonomecho, Rumoi, Hokkaido, 077-8511, Japan
| | - Yukihiko Kawasaki
- Department of Pediatrics, Sapporo Medical University School of Medicine, South-1, West-16 Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| |
Collapse
|