Bilateral Pleural Effusion as the Initial Manifestation of Rheumatoid Arthritis Without Articular İnvolvement: Case Report and Literature Review

Abstract

Pulmonary involvement due to rheumatoid arthritis (RA) usually occurs after articular involvement, and pleural involvement is rarely seen before articular involvement. A 62-year-old male patient was complaining of exertional dyspnea. He had bilateral pleural effusion on chest radiograph and high C-reactive protein and erythrocyte sedimentation rate in laboratory tests. As a result of exclusion of other etiologies of bilateral pleural effusion and positive results of rheumatoid factor and anti-cyclic citrullinated peptide antibody in the serum, the patient was diagnosed with RA. This case emphasizes that RA, which is a systemic rheumatic disease, should always be among the preliminary diagnoses in the presence of bilateral pleural effusion, even if there is no known RA diagnosis.

Keywords

• anti-cyclic citrullinated peptide antibody
• rheumatoid arthritis
• pleural effusion