Symptoms in the lungs and not in the joints in a Puerto Rican arthritis patient

In Puerto Rico, a case of rheumatoid arthritis was presented whose diagnosis did not come from deterioration of the joints but from abnormalities developed in the respiratory system.

Dr. Alexis Rivera González, one of the authors of the case. Photo: Journal of Medicine and Public Health.

In Puerto Rico are becoming more and more evident cases of obstructive pulmonary disease chronic (COPD, for its acronym in English), a condition that the island’s doctors are prepared to diagnose and treat, in accordance with the pre-established guidelines and the protocols of the health professionals specialized in it. However, a man of 53 years of age presented to Saint John’s Hospital with a mixed pattern of COPD and fibrosis. At an age when people -generally- still carry a normal and functional lifeIt is patient -who was a mechanic by profession- was already dependent on an oxygen tank.

I had deviation on the right side, fibrosisand we did a study of pulmonary artery diameter and aorta. It also gave a positive result for arthritis rheumatoid. She had a catheterization for pulmonary hypertension and is now in the process of doing a biopsy and seeing if she responds to treatment. It is long term, it is a slow process. We hope you have a better quality of life,” said Dr. Alexis Rivera González.

Rivera said developing these complications together is not a common occurrence. “What happens is that with the Rheumatoid arthritis, extrasynovial manifestations are expected. But, curiously, this patient does not have any joint manifestations. That is why it was not suspected because he did not have any finger pain, but when we do the study, the condition appears“, he mentioned. However, the man in question was associated with the disease with pulmonary and not joint manifestations.

The doctors conclude that it is a case of Rheumatoid arthritisdue to suffering from fibrosis and of an anomalous behavior that does not correspond to the cases of COPD, since “nobody with COPD in less than six years depends on oxygen”, expressed the Dr. Rivera Gonzalez. Currently, the man is under steroid and drug treatments,while the doctors expect a positive answer of the same. But, as mentioned earlier in this article, you will have a biopsy later to find out the details.

For now, Dr. Rivera announced that the patient -already at least- uses oxygen only at night and that the pulmonologists and rheumatologists on the case are working to restore the mechanic’s quality of life.

On the island it is being shown that patients con Rheumatoid arthritis they also develop pulmonary hypertension, a fact that was more noticeable in other countries. In this regard, Rivera mentioned the following: “I make a call so that not only anchoring of COPD and looking further afield”, declared the doctor. It should be noted that pulmonary hypertension is a disease that manifests itself more in men than in women, an event that until now is unknown to medical science.