Methods: A 63-year-old male, recently diagnosed with RA, was admitted to the intensive
care unit with symptoms of shortness of breath. He was found to be in respiratory distress
and in hypoxemic respiratory failure needing intubation and mechanical ventilation. Physical
examination was significant for scattered rhonchi and bibasilar crackles on lung
auscultation. The initial laboratory data revealed white blood cell count 12,000/μl with 66%
neutrophils, 22% lymphocytes, 10% monocytes, 0% eosinophils and 1% basophils, lactate …