{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T19:29:47Z","timestamp":1786562987892,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Rheumatoid arthritis is a systemic inflammatory disorder primarily affecting joints but not limited to the joints alone. Extra\u2010articular manifestations involve skin, ocular, gastrointestinal, pulmonary, cardiac, renal, neurological, and hematological systems. Among them, skin manifestations (20%) are most common, presenting as nodules on the extensor surfaces of the upper and lower extremities. In rare cases these nodules can also be detected within the heart and lungs. Interestingly, rheumatoid nodules are often seen in patients on leflunomide, methotrexate, or tumor necrosis factor\u2010alpha antagonists. Nevertheless, definitive diagnosis requires a histopathological analysis. In this case report, we presented a 49\u2010year\u2010old male patient with a relatively short period of disease activity leading to rheumatoid nodules in the lungs. Considering the ongoing COVID\u201019 pandemic and that tuberculosis was still endemic in Kazakhstan, achieving the definite diagnosis was challenging. Initial imaging study revealed bilateral polysegmental pneumonia. The tests for COVID\u201019 and pulmonary tuberculosis were negative. A follow\u2010up chest computed tomography scan had signs of disseminated lung lesions of unknown origin. Lung biopsy showed a morphological picture of productive granulomas characteristic for tuberculosis. However, at the second look, typical scarring granulomas typically seen in rheumatoid nodules were observed.<\/jats:p>","DOI":"10.1111\/1756-185x.14904","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T23:54:40Z","timestamp":1696290880000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A case report of extra\u2010articular manifestation of rheumatoid arthritis: Rheumatoid nodules in lungs"],"prefix":"10.1111","volume":"27","author":[{"given":"Saltanat","family":"Bektyrganova","sequence":"first","affiliation":[{"name":"Department of Internal Medicine JSC National Scientific Medical Center  Astana Kazakhstan"},{"name":"Astana Medical University  Astana Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doskhan","family":"Kozhakhmet","sequence":"additional","affiliation":[{"name":"Nazarbayev University School of Medicine  Astana Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey","family":"Kim","sequence":"additional","affiliation":[{"name":"Nazarbayev University School of Medicine  Astana Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abay","family":"Baigenzhin","sequence":"additional","affiliation":[{"name":"JSC National Scientific Medical Center, Chairman of the Board  Astana Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7842-1871","authenticated-orcid":false,"given":"Galymzhan","family":"Togizbayev","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Kazakh National Medical University named after S.D. 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