Department of Respirology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Mod Rheumatol Case Rep. 2020 Jul;4(2):248-252. doi: 10.1080/24725625.2020.1755516. Epub 2020 Apr 30.
A 52-year-old woman was diagnosed as having anti-centromere antibody (ACA)-positive primary Sjögren syndrome (pSS). Eight years later, she visited our hospital because she had developed dyspnoea. She was diagnosed as having pulmonary arterial hypertension (PAH) with pulmonary veno-occlusive disease on the basis of the results of right heart catheterisation, a severe decrease in diffusing capacity of the lung for carbon monoxide (D, 17%) and desaturation (69%) after a 6-minute walk test. She was also diagnosed as having limited cutaneous systemic sclerosis (lcSSc) because she had developed finger sclerosis. The six-minute walk distance had improved by 54 m 3 months after commencing treatment with tadalafil. Clinicians should be alert to the possibility of patients with ACA-positive SS developing lcSSc and PAH during their clinical course.
一位 52 岁女性被诊断为抗着丝点抗体阳性原发性干燥综合征(pSS)。8 年后,她因呼吸困难就诊于我院。基于右心导管检查结果、一氧化碳弥散量(D,17%)和 6 分钟步行试验后血氧饱和度(69%)严重下降,诊断为肺动脉高压(PAH)合并肺静脉闭塞病。此外,由于手指硬化,还诊断为局限性皮肤系统性硬化症(lcSSc)。开始使用他达拉非治疗 3 个月后,6 分钟步行距离增加了 54 米。临床医生应警惕抗着丝点抗体阳性 SS 患者在其病程中出现 lcSSc 和 PAH 的可能性。