関節リウマチと非結核性抗酸菌症合併例の肺病変について

CT images of lung abnormalities in cases with coexisting rheumatoid arthritis and nontuberculous mycobacteriosis

膠原病の関節リウマチ（rheumatoid arthritis：RA）と感染症の非結核性抗酸菌症（nontuberculous mycobacteriosis：NTM）は，中高年に頻度が高く，いずれも気道病変を伴う疾患である。RA患者のNTM発病率（粗罹患率）は一般人口（50歳以上）に比して2倍，生物学的製剤が投与された場合には10倍と報告されている^1）。両者は画像上の類似点が多く，またその合併や生物学的製剤の使用は患者予後に影響を与えることが危惧されている。

Rheumatoid arthritis（RA）and nontuberculous mycobacteriosis（NTM）are more frequent in middle-aged and elderly people, both of which are diseases with respiratory tract lesions. When we examined the clinical and imaging features of 19 cases of complications of RA and NTM lung lesions experienced in our hospital, the majority were overwhelmingly in middle-aged and elderly women, and the average difference between the onset of the two was more than 9 years in average. There were many cases of developing NTM after a long period of time after suffering from RA. The disease of NTM tended to be progressive in cases with cavities, but the use of biologics was not related to progression.