Abstract
Bronchiectasis is one of the respiratory diseases which are complicated with rheumatoid Arthritis (RA). Pulmonary infection related with bronchiectasis influences the choice of treatment for RA. Rhuematologists hesitate to administer immunosuppressive agents and/or biological drugs to RA patients with bronchiectasis because they are at a higher risk for pulmonary infection than those without bronchiectasis. When RA patients with bronchiectasis have pulmonarysurgery done, they will have a lower risk for pulmonary infection and a probability of treating RA with immunosuppressive agents and/or biological drugs. Therefore we should consider surgery for bronchiectasis as a treatment unless a series of antibiotics have therapeutic effects on RA patients with bronchiectasis.
A 66-year-old woman with RA and bronchiectasis suffered repeated pulmonary infection. Although her RA control was not sufficient, it was difficult to treat her with immunosuppressive agents such as MTX and/or biological drugs. Consequently we operated on her for bronchiectasis by pulmonary lobectomy to reduce the risk of pulmonary infection. After the surgery was done, pulmonary infection seldom occurred and we have successfully introduced MTX to her treatment.However her RA activity is still high and her subjective complaints have not remarkably improved.
Therefore we will introduce biological drugs and move her treatment to the next stage.
