Dalvi Vrishali, Gonzalez Emilio B, Lovett Louis
Atlanta Medical Center, Atlanta, GA 30312, USA.
Clin Rheumatol. 2007 Aug;26(8):1339-43. doi: 10.1007/s10067-006-0351-x. Epub 2006 Aug 5.
Sjõgren's disease is one of the most common rheumatological diseases and can present with a variety of extra-glandular manifestations. Lymphocytic Interstitial Pneumonitis (LIP) is the most common lung pathology in these patients. It is important to know and recognize this condition because it is potentially treatable. It is also frequently misdiagnosed and treated as infectious pneumonia multiple times before the correct diagnosis is made. It is a benign lymphoproliferative disorder characterized histologically by interstitial infiltration with polyclonal lymphocytes and plasma cells. High-resolution CT scan of the lungs shows extensive areas of ground-glass attenuation and interlobular septal thickening with scattered thin-walled cysts. An open-lung biopsy is the best method of diagnosing this condition, as less invasive techniques do not provide an adequate tissue specimen. LIP occurs in a wide variety of settings such as autoimmune disease, HIV disease, and as an adverse reaction to some medications; it is, therefore, considered to be a nonspecific response to many stimuli. The treatment usually consists of corticosteroids and other immunosuppressants, though there have been no controlled trials to date. Establishment of a registry may help better evaluate and treat this disease. We present the case of a patient who was diagnosed with LIP secondary to Sjögren's syndrome and also review the literature available.
干燥综合征是最常见的风湿性疾病之一,可伴有多种腺外表现。淋巴细胞间质性肺炎(LIP)是这些患者中最常见的肺部病变。了解和认识这种疾病很重要,因为它有可能得到治疗。在正确诊断之前,它也经常被误诊并多次当作感染性肺炎进行治疗。它是一种良性淋巴增生性疾病,组织学特征为间质有多克隆淋巴细胞和浆细胞浸润。肺部高分辨率CT扫描显示广泛的磨玻璃样密度减低区和小叶间隔增厚,并伴有散在的薄壁囊肿。开胸肺活检是诊断这种疾病的最佳方法,因为侵入性较小的技术无法提供足够的组织标本。LIP发生于多种情况,如自身免疫性疾病、HIV疾病以及作为对某些药物的不良反应;因此,它被认为是对多种刺激的非特异性反应。治疗通常包括使用皮质类固醇和其他免疫抑制剂,不过迄今为止尚无对照试验。建立一个登记系统可能有助于更好地评估和治疗这种疾病。我们报告一例继发于干燥综合征的LIP患者病例,并对现有文献进行综述。