SLE, well how is this going to
then present with lung disease?
You're gonna find an acute
however you will not
find as many fibroblast.
Diffuse lung disease here
histopathologically referred to
as being nonspecific interstitial
pneumonitis, which is our topic.
And the pleural effusion that you'd find
here within the lung would be exudative
in other words, it
would be protein-rich.
In rheumatoid artritis, what kind of
issue might you find in the lung?
often presents with progressive fibrosis
similar to usual interstitial pneumonitis,
and we had talked about that,
now do not get confused here.
If you find abundance of fibrosis
dealing with rheumatoid arthritis,
that is going to be idiopathic
underlying disorder as far as its
response to corticosteroids,
minimal at the best.
However, if you find minimal fibrosis,
think of it as being a continuum,
then it will be the
may also see rheumatoid nodules.
Now if you find rheumatoid nodules, and you
have feet and arms likely to be affected,
autoimmune disease, you would then
find the symmetric type of lesion
in which your patient now has ulnar
see this right here
This is a cluster type of diagnosis,
you see something like this in a patient
when he goes out to dinner or whatever
then you know that patient is
unfortunately, I say that's unfortunate
because it's absolutely debilitating.
and the type of autoantibody that you
might find is a rheumatoid factor.
and the rheumatoid factor is quite dangerous
because the more of it that you find,
then the prognosis of your
patient is that much worse.
rheumatoid nodules could be a part
of a rheumatoid arthritis,
same pathology as periepheral nodules.
also with this type of
fibrosis that is occuring,
at some point in time, say that
it is around the peribronchiolar
and if it is around the peribronchioles,
with fibrosis what is it going to do?
it is then going to obliterate,
obliterate the bronchiole
Remember please that is a very very
nonspecific type of pathogenesis,
any condition in which there is increased
causing damage to the bronchiole
resulting in bronchiolitis obliterans
Pleural effusion here, also possible.
What are we looking at for ?
Low glucose and the effusion might
actually appear as being green
Interesting, extremely specific.
That should tip you off,
that Oh no, my patient with rheumatoid
arthritis is having lung issues as well.
Keep that in mind, very important.
And also, later on at some point,
we'll talk about pneumoconiosis
with restrictive lung disease and
in that patient with pneumoconiosis
and that might have rheumatoid
nodules, the combination of the two,
you call that Caplan syndrome.
I'll refer to that again when we get
into further detail with pneumoconiosis.
Not to worry, at this point all we're dealing
with is fibrosis or minimal, depending.