Clinical case of differential diagnosis of lung cavities in rheumatoid arthritis

Rheumatoid arthritis (RA) is a disease that, in addition to affecting joints, is characterized by systemic damage to various localizations, including the lungs. Damage to the respiratory system occurs in about 30 – 40% of cases and may manifest in various ways, necessitating differential diagnosis. One of the manifestations is rheumatoid nodules, which can lead to the formation of cavities in the lungs, hemoptysis, and pneumothorax. The aim of the work was to demonstrate a clinical case of a long-term follow-up of a patient with lung damage due to rheumatoid arthritis. Conclusion. The article presents a clinical case of a patient with seropositive RA, who developed lung cavities accompanied by hemoptysis against the background of a prolonged course of the disease. Other causes, such as pulmonary embolism, malignant neoplasms, specific infection, and other systemic diseases, were excluded. Lung damage due to taking a drug from the TNF-alpha inhibitor group (Etanercept) was also considered; however, this option seemed unlikely due to the appearance of new foci after the drug withdrawal. An important step in making a diagnosis in this case was histological examination. The studied material contains signs of pulmonary vasculitis and rheumatoid nodules. Thus, visceral lung damage in RA was verified. This clinical observation demonstrates the need for differential diagnosis of lung cavities in RA with infectious,