BOF: 30
A 46-year-old female who is
known to have rheumatoid arthritis presents with progressive breathlessness. On
examination of her chest she is noted to have fine late inspiratory crepitations
at both lung bases.
Which of the following drugs
that she has taken may be responsible for this condition?
a)
Prednisolone
b)
Diclofenac
c)
Penicillamine
d)
Sulphasalazine
e)
Penicillamine
Answer:
d)
The history of progressive
breathlessness in a patient with rheumatoid arthritis may have multiple causes.
However, the finding of fine late inspiratory crepitations at both bases points
to a diagnosis of pulmonary fibrosis. (See ACES for
PACES page 264)
Many drugs cause pulmonary
fibrosis and sulphasalazine is one of them.
The other drugs used in
rheumatoid arthritis that may cause pulmonary fibrosis are gold and
methotrexate.
Nalidixic acid does not cause
pulmonary fibrosis but nitrofurantoin does do so.
Last Updated: 16/04/06
