両側胸水を伴う間質性陰影を呈した一次性Sjogren症候群の1症例  [in Japanese] Primary Sjogren's Syndrome Accompanied by Pleural Effusion  [in Japanese]

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Abstract

症例は40歳女性. 発熱, 右頸部痛を主訴として入院となる. 入院後より頬部紅斑に加えて両側下肺野の間質性陰影と胸水が出現した. 経気管支的肺生検ではリンパ球の浸潤を伴う間質の肥厚が認められ, BALFでは総細胞数とCD8リンパ球の増加が認められた. 口腔内の乾燥症状に対して施行された Schirmer テストおよびガムテストでは著明な涙腺量, 唾液腺量の低下が認められた. 膠原病関連の血清学的検査では抗核抗体80倍, 抗SS-A抗体64倍, 抗SS-B抗体8倍と異常高値が認められ, 一次性シェーグレン症候群 (以下, SjSと略) と診断された. 頬部紅斑に関してはSjSの皮膚病変と判断した. プレドニゾロン60mg/日の使用により約1ヵ月間で症状および胸部X線所見は軽快した. 胸水を伴うSjS症例は極めて稀であり, 興味ある症例と思われた.

A 40-year-old woman was admitted to the hospital because of fever and right cervical pain. Facial erythema developed after admission, along with interstitial shadows and pleural effusion in both lower lung fields. Microscopical examination of transbronchial lung biopsy specimens showed infiltration by lymphocytes and thickening of alveolar walls. Analysis of bronchoalveolar lavage fluid revealed an abnormally high number of cells and CD8 lymphocytes. Schirmer's test and a gum test showed abnormaly low lacrimation and salivation. Anti-nuclear antibody, and antibodies against SS-R, and SS-B were present. These findings led to the diagnosis of primary Sjögren's syndrome accompanied by pleural effusion. Facial erythema was regarded as a symptom of Sjögren's syndrome. Prednisolone was given (60m/day), and the symptoms and the abnormality on the chest roentgenogram resolved within about 1 month.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 33(11), 1325-1329, 1995-11-25

    The Japanese Respiratory Society

References:  15

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008109007
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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