THE PLEURAL AND PULMONARY COMPLICATIONS OF RHEUMATOID ARTHRITIS

Abstract

RHEUMATOID arthritis has for some time been considered to be a gen-eralized disease involving many tissues and organs in addition to the joints, and the possible occurrence of pulmonary and pleural lesions is compatible with this conception. Occasional references to chest complications in chronic rheumatism are to be found in the early medical literature.1"6 These, however, must be treated with reserve, in view of the confusion that existed in the classification of chronic arthritis and the prevalence of tubercu-losis at that time, as well as the frequency of hypostatic pneumonia among immobile and debilitated subjects. Such early reports were those of Fullerx in 1860, who considered that pleurisy and even empyema were complications of "rheumatic gout, " and Charcot2 in 1881, who regarded pleurisy and chronic pneumonia as examples of the visceral involvement which occurred late in the course of rheumatoid arthritis. Bronchitis, phthisis and pneu-monia were cited as complications of rheumatoid arthritis by Bannatyne,8 and further mention of the frequent occurrence of pleurisy was made by