Acute Hypoxemic Respiratory Failure with Progressive Dyspnea in an Elderly Woman with Autoimmune Disease

Case Presentation An 82-year-old woman with a known medical history of confirmed seronegative rheumatoid arthritis and confirmed statin-induced autoimmune hepatitis also had comorbid hypertension and supraventricular tachycardia. Chief Complaints Worsening dyspnea for 4 days Nonproductive cough Associated: Lower extremity edema Chills History of Present Illness No fever, hemoptysis, or pleuritic chest pain No recent travel or sick contacts Progressive respiratory symptoms on a background of chronic lung disease Past Medical & Treatment History RA diagnosed in May 2024 Initially treated with hydroxychloroquine Transitioned to golimumab (TNF-α inhibitor) 3 months prior AIH attributed to atorvastatin 40-pack-year smoking history (quit 23 years ago) Examination Findings Required 5 L/min oxygen Oxygen saturation: 93% on oxygen Tachypnea present Heart rate: 57 bpm (on sotalol) Chest exam:…