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肺朗格汉斯细胞组织细胞增多症:干燥综合征患者间质性肺炎的罕见病因。

Pulmonary Langerhans Histiocytosis: an uncommon cause of interstitial pneumonia in a patient with Sjögren syndrome.

作者信息

González García Andrés, Callejas Rubio José Luis, Ríos Fernández Raquel, Ortego Centeno Norberto

机构信息

Department of Internal Medicine, University Hospital Ramón y Cajal, Ctra. Colmenar Viejo Km. 9, 100, 28035, Madrid, Spain.

Systemic Autoimmune Diseases Unit, Hospital San Cecilio, Granada, Spain.

出版信息

Clin Rheumatol. 2016 Mar;35(3):825-8. doi: 10.1007/s10067-015-2924-z. Epub 2015 Apr 19.

Abstract

Sjögren syndrome is a chronic, systemic, and autoimmune disorder that targets exocrine glands by remarkable B cell hyperactivity. Eventually, it is associated with extra-glandular clinical manifestations that affect essentially any organ system, including pulmonary involvement. Interstitial lung disease is one of the most serious pulmonary complications, and the early diagnosis is essential to initiate a prompt therapy. On the other hand, Sjögren syndrome could present concomitantly with several rheumatologic diseases such as systemic lupus erythematosus or rheumatoid arthritis. Pulmonary Langerhans Histiocytosis is a rare clonal proliferative disease characterized by pulmonary involvement by cells phenotypically similar to Langerhans cells. We describe the case of a nonsmoker 62-year-old woman with Sjögren syndrome who presented concomitantly a Pulmonary Langerhans Histiocytosis mimicking a pulmonary complication of its Sjögren. Fortunately, she had a well response to corticosteroids and azathioprine regimen. The aim of the paper is to emphasize the importance of the good differential diagnosis related to the pulmonary involvement. To the best of our knowledge, this is the first description of these two entities in the literature.

摘要

干燥综合征是一种慢性、全身性自身免疫性疾病,以显著的B细胞过度活跃靶向外分泌腺。最终,它会伴有影响几乎任何器官系统的腺外临床表现,包括肺部受累。间质性肺病是最严重的肺部并发症之一,早期诊断对于及时开展治疗至关重要。另一方面,干燥综合征可能与几种风湿性疾病同时出现,如系统性红斑狼疮或类风湿关节炎。肺朗格汉斯细胞组织细胞增多症是一种罕见的克隆增殖性疾病,其特征是肺部出现表型类似于朗格汉斯细胞的细胞。我们描述了一名62岁不吸烟的干燥综合征女性病例,该患者同时出现了酷似干燥综合征肺部并发症的肺朗格汉斯细胞组织细胞增多症。幸运的是,她对皮质类固醇和硫唑嘌呤治疗方案反应良好。本文的目的是强调与肺部受累相关的良好鉴别诊断的重要性。据我们所知,这是文献中对这两种疾病的首次描述。

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