Lwin Ni Ni, Hlaing Wut Y, Sta Lucia Aprilee, Tasmin Ruhina
Internal Medicine, Harlem Hospital Center, New York, USA.
Cureus. 2025 Jul 13;17(7):e87826. doi: 10.7759/cureus.87826. eCollection 2025 Jul.
Systemic sclerosis is one of the rare autoimmune disorders characterized by fibrosis, damage to the vascular system, and immune dysregulation. Interstitial lung disease is one of the leading causes of morbidity and mortality among pulmonary manifestations of systemic sclerosis. Diagnosing systemic sclerosis-related interstitial lung disease (SSc-ILD) is often delayed due to symptoms such as cough and dyspnea that mimic common respiratory conditions such as pneumonia or bronchitis. We report a 48-year-old woman who presented with recurrent pneumonia-like symptoms. Based on serological and imaging findings, she was diagnosed with SSc-ILD. Her condition improved with antibiotics, immunosuppressants, and antifibrotic agents. The diagnosis and management of SSc-ILD are still challenging, especially when initial symptoms are similar to those of more common conditions such as recurrent pneumonia. An exact diagnosis can only be made by using clinical judgment along with imaging and serologic testing, as shown in this case. Starting treatment early with immunosuppressive and antifibrotic therapies can help slow disease progression and improve quality of life. In complex cases like this, it can be particularly beneficial to have specialists from different fields collaborate, which can make a significant difference in patient care.
系统性硬化症是一种罕见的自身免疫性疾病，其特征为纤维化、血管系统损伤和免疫失调。间质性肺病是系统性硬化症肺部表现中导致发病和死亡的主要原因之一。由于咳嗽和呼吸困难等症状与肺炎或支气管炎等常见呼吸道疾病相似，系统性硬化症相关间质性肺病（SSc-ILD）的诊断往往会延迟。我们报告了一名48岁女性，她反复出现类似肺炎的症状。根据血清学和影像学检查结果，她被诊断为SSc-ILD。使用抗生素、免疫抑制剂和抗纤维化药物后，她的病情有所改善。SSc-ILD的诊断和管理仍然具有挑战性，尤其是当初始症状与复发性肺炎等更常见疾病的症状相似时。如本病例所示，只有结合临床判断以及影像学和血清学检查才能做出准确诊断。早期开始使用免疫抑制和抗纤维化疗法进行治疗有助于减缓疾病进展并提高生活质量。在这样的复杂病例中，让不同领域的专家进行协作可能特别有益，这对患者护理会产生重大影响。
