Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 45-year-old female presented to the rheumatology clinic with complaint of pain and swelling of multiple small joints of the hands and feet. She also complained of cough and shortness of breath onset around the same time. Since her cyclic citrullinated peptide antibody (anti-CCP) and rheumatoid factor tests were positive, rheumatoid arthritis (RA) was diagnosed and she was started on prednisone with plans for additional disease modifying therapy. Chest X-ray showed a small right pleural effusion. While additional pulmonary evaluation was being planned, a few weeks later she presented with dyspnea, fever and tachycardia. Spiral CT showed pulmonary emboli and increased pleural effusion and patient was started on anticoagulation. A chest tube was placed and exudative pleural effusion was drained. Cytology sample from bronchoscopy raised concerns for adenocarcinoma. Open lung biopsy confirmed moderately differentiated adenocarcinoma. The patient died of lung cancer in the hospital 8 weeks from her diagnosis of RA. We describe a case of paraneoplastic polyarthritis with positive anti-CCP antibody test which has not been reported before. We also review the literature on paraneoplastic arthritis which has been described in association with various other malignancies besides lung cancer.
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PMID:Report of anti-CCP antibody positive paraneoplastic polyarthritis and review of the literature. 2001 60

We present a case of a 61-year-old woman with several months of gradually worsening shortness of breath, requiring multiple hospitalizations with acute hypoxemic respiratory failure. She was initially treated for eosinophilic pneumonia presumed to be secondary to medications or rheumatoid lung without much improvement. Her subsequent chest CT showed honeycombing and diffuse ground-glass opacities, and she was found to have elevated rheumatoid factor (RF) and anti-CCP antibody titers without extrathoracic features of rheumatoid arthritis. This clinical scenario was suggestive of an interstitial lung disease (ILD) due to occult underlying connective tissue disorder (CTD), along the lines of the recently proposed entity interstitial pneumonia with autoimmune features (IPAF). She continued to deteriorate rapidly and passed away after experiencing recurrent exacerbations. As there is limited evidence to explain the clinical course of such patients, there is a need for prospective research to develop tailored regimens to prevent progression or even reverse the disease process.
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PMID:A Case of Interstitial Pneumonia with Features of Autoimmunity. 3326 Dec 31