[
    {
        "id": "osp-2390",
        "type": "article-journal",
        "title": "Pancreatic Rheumatoid Granulomas: A Case Report of a Rare Complication of Rheumatoid Arthritis",
        "author": [
            {
                "family": "Elshebli",
                "given": "Sanad"
            },
            {
                "family": "Abureesh",
                "given": "Omar"
            },
            {
                "family": "Awad",
                "given": "Heyam"
            }
        ],
        "URL": "https://omanscience.com/en/articles/pancreatic-rheumatoid-granulomas-a-case-report-of-a-rare-complication-of-rheumatoid-arthritis",
        "language": "en",
        "issued": {
            "date-parts": [
                [
                    2021
                ]
            ]
        },
        "container-title": "Oman Medical Journal",
        "DOI": "10.5001/omj.2021.37",
        "publisher": "Oman Medical Specialty Board",
        "ISSN": "1999-768X",
        "abstract": "Cutaneous granulomas presenting as skin nodules are the most common extra-articular manifestations of rheumatoid arthritis (RA). Granulomas are defined as a form of chronic inflammatory response characterized by aggregation of activated histiocytes. Visceral granulomas are a rare complication of long-standing RA and have been described twice in the literature. We report a case of a 55-year-old woman with a 15-year history of RA. The patient presented with epigastric pain and weight loss. Imaging studies showed a large soft tissue mass in the head of the pancreas, which was suspected to be malignant. A Whipple procedure was performed, and histological examination revealed multiple non-caseating granulomas with central liquefaction and neutrophilic infiltrate. Ziehl-Neelsen stain for acid-fast bacilli and tuberculosis polymerase chain reaction were negative. The patients’ granulomas were diagnosed as rheumatoid granulomas. Five years after diagnosis, the patient is doing well and has no complications."
    }
]