{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T05:05:52Z","timestamp":1784351152109,"version":"3.55.0"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,3,16]]},"abstract":"<jats:p>Rheumatoid pleural effusion is generally responsive to corticosteroids, but refractory cases require consideration of second-line therapy. Here we report the case of a 61-year-old man with rheumatoid arthritis (RA) who developed a large right-sided pleural effusion and was successfully treated with abatacept. Thoracocentesis showed a sterile exudate and an elevated adenosine deaminase level. The methotrexate and etanercept used to treat the RA were withheld initially while he underwent a trial of prednisolone 40\u2009mg\/day for the pleural effusion. However, the effusion did not respond to this therapy. Thoracoscopic biopsy of the right pleura revealed fibrotic changes with lymphocyte infiltration mainly composed of CD4<jats:sup>+<\/jats:sup>T cells and B cells but no evidence of malignancy or infection. The patient was started on abatacept and resumed methotrexate. The treatment was effective in our case. Abatacept should be considered as a treatment option in patients with refractory rheumatoid pleural effusion.<\/jats:p>","DOI":"10.1136\/bcr-2017-224034","type":"journal-article","created":{"date-parts":[[2018,3,28]],"date-time":"2018-03-28T13:55:51Z","timestamp":1522245351000},"page":"bcr-2017-224034","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment of refractory rheumatoid pleural effusion with abatacept"],"prefix":"10.1136","volume":"2018","author":[{"given":"Shunichi","family":"Fujita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Mukai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiko","family":"Akagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,3,28]]},"reference":[{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2006.03.002"},{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.2","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00008014"},{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-007-0322-9"},{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.4","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.ijmyco.2016.07.001","article-title":"Evaluation of different laboratory methods for rapid diagnosis of tuberculous pleurisy","volume":"5","author":"Amer","year":"2016","journal-title":"Int J Mycobacteriol"},{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2010.01723.x"},{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.6","doi-asserted-by":"publisher","DOI":"10.1136\/ard.47.5.394"},{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050524"},{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.8","doi-asserted-by":"publisher","DOI":"10.1159\/000084047"},{"key":"2025042703145967000_2018.mar28_1.bcr-2017-224034.9","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.3109\/14397595.2013.874745","article-title":"A case of bilateral rheumatoid pleuritis successfully treated with tocilizumab","volume":"24","author":"Ohtsuka","year":"2014","journal-title":"Mod Rheumatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-224034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T10:15:09Z","timestamp":1745748909000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-224034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,28]]},"references-count":9,"alternative-id":["10.1136\/bcr-2017-224034"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-224034","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,28]]}}}