Abstract
We reported the first case of interstitial pneumonitis in a patient with rheumatoid arthritis treated with bucillamine in 1989. Since then, thirteen cases of bucillamine-induced pneumonitis have been reported. Here, we report the second case in our department. From analysis of these cases, we propose the following patient background as risk factors for bucillamine-induced pneumonitis,
Risk fartors of lung injury
1. Old age. Older patient with RA.
2. Patient who has suffered from RA for a long time.
3. Serum rheumatoid factor is highly positive. High RA activity, e.g. high RF titer.
4. Slight manifestation of lung fibrosis before the abrupt change. Pre-existing pulmonary injury of RA.
5. Exellent effect of bucillamine on rheumatoid disease activity in most cases. Good response to the drug. High responder to the drug, in general.
6. HLA typing, e.g. DR2, DR4 positive.
7. DLST or patch test with bucillamine is positive.
