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A 51-year-old female had chronic throiditis under treatment for 11 years. In June 2002, she was diagnosed as having progressive systemic sclerosis and Sjögren's syndrome with finger swelling and drying buccal cavity. She was referred to our hospital, as a chance x-ray revealed abnormalities. An x-ray showed bilateral hilar lymphadenopathy and a CT showed mediastinal and bilateral hilar lymphadenopathy and diffuse reticular opacities in bilateral lung fields. Bronchoalveolar lavage revealed elevated lymphocytes (44%) with high CD4/CD8 ratio (4.6). A transbronchial lung biopsy revealed noncaseating epithelioid cell granulomas compatible with sarcoidosis. She was already on 2.5mg of predonisolone every other day for Sjögren's syndrome. After 4 months, another chest x-ray showed slight improvement of bilateral hilar lymphadenopathy, Though the case reports of sarcoidosis in association with autoimmune disease have been on the increase, we report a rare case of sarcoidosis with two autoimmune diseases.
日本サルコイドーシス/肉芽腫性疾患学会の論文