A CLINICAL and pathological concept of a malignant form of rheumatoid arthritis has been presented.1 This concept pertained to patients with active rheumatoid arthritis with a fulminating clinical course, who at autopsy revealed widespread visceral lesions differing from those seen in patients dying with rheumatic fever. The clinical significance of rheumatoid involvement of the heart and lungs in patients with rheumatoid arthritis has been emphasized in recent literature.2-9 It is the purpose of this communication to present a case report of a patient with malignant rheumatoid disease. The patient's clinical course suggested a diffuse inflammatory process characterized by active peripheral rheumatoid arthritis, pleuritis and pericarditis with associated effusions, severe aortic stenosis associated with unremitting congestive heart failure, and sudden death. The clinical manifestations were attributed after postmortem study to be a part of the rheumatoid process.
Report of a Case
The patient (VAH 5785), a 43-year-old white male