[Rheumatoid arthritis, obliterating bronchiolitis and D-penicillamine. Apropos of a new case with ultrastructural examination and review of the literature].

Over recent years, several cases have been reported of bronchiolitis obliterans, of very rapid onset and serious clinical course in patients with rheumatoid arthritis being treated with D-Penicillamine. After reporting a new case, the authors stress the unusual features of this bronchiolar condition which is probably of iatrogenic origin and irreversible, with death occurring within a few years. The pathogenesis is poorly understood and many questions still remain concerning the relationships between rheumatoid arthritis, the bronchiolar lesions and D-Penicillamine in this disease of pulmonary collagen. The ultrastructural examination and the morphometric examination of this new case suggest the presence of predominantly type III collagen, which is normally present in the lungs in only small quantities.