Fatal bronchiolitis obliterans in a patient with juvenile rheumatoid arthritis receiving chrysotherapy

J Rheumatol. 1994 Mar;21(3):549-51.


Bronchiolitis obliterans has been described in adults with rheumatoid arthritis, particularly in association with D-penicillamine treatment, but to our knowledge has not been reported in juvenile rheumatoid arthritis (JRA). We describe a 12-year-old girl with JRA who developed bronchiolitis obliterans after a 6-month course of intramuscular gold. She presented with severe obstructive airway disease (FEV1, 17% predicted) unresponsive to bronchodilators, without obvious pathology on chest radiograph. Despite aggressive immunosuppressive therapy and eventual lung transplantation, she died 3 1/2 years after her initial diagnosis of JRA. Although rare, bronchiolitis obliterans must be considered in the differential diagnosis of respiratory distress in children with JRA.

Publication types

  • Case Reports

MeSH terms

  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / drug therapy
  • Bronchiolitis Obliterans / diagnosis
  • Bronchiolitis Obliterans / drug therapy
  • Bronchiolitis Obliterans / etiology*
  • Bronchiolitis Obliterans / pathology
  • Bronchiolitis Obliterans / surgery
  • Child
  • Combined Modality Therapy
  • Fatal Outcome
  • Female
  • Gold / administration & dosage
  • Gold / therapeutic use*
  • Humans
  • Injections, Intramuscular
  • Lung Transplantation
  • Methylprednisolone / therapeutic use
  • Prednisone / therapeutic use


  • Gold
  • Prednisone
  • Methylprednisolone