[Bronchiolitis obliterans with organized pneumonia: a rare complication of primary Gougerot-Sjögren syndrome].
BACKGROUND
Bronchiolitis obliterans organizing pneumonia (BOOP) is characterized by plugs of granulation tissue in bronchioles, alveolar ducts and alveoli. This pulmonary disorder has been reported in some cases in relation to drug consumption (D-penicillamine, amiodarone), with bacterial or viral infections (Mycoplasma pneumoniae, HIV), and with systemic diseases, such as rheumatoid arthritis. To our knowledge, only three cases of association BOOP-Sjögren's syndrome have been reported.


METHODS
We report three new cases of BOOP. These patients presented a primary Sjögren's syndrome without clinical or biological abnormalities suggestive of other autoimmune diseases. Initial presentation was an acute pulmonary disorder mimicking a bacterial pneumonia. Two patients had cutaneous vasculitis and the third vasculitic neuropathy. Corticosteroid therapy was begun and was quickly successful. None of the patients presented a relapse of BOOP.


CONCLUSIONS
The incidence of BOOP is probably underestimated in patients with primary Sjögren's syndrome without cutaneous vasculitis. In case of pneumonia with antibiotic resistance, an immunological mechanism should be considered.
Lambert
M
M
Service de médecine interne, hôpital Claude-Huriez, CHU, Lille, France.
Hebbar
M
M
Viget
N
N
Hatron
P Y
PY
Hachulla
E
E
Devulder
B
B
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018549:Cryptogenic Organizing Pneumonia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018410:Pneumonia, Bacterial / Q000175:diagnosis; D012859:Sjogren's Syndrome / Q000150:complications*
D000305:Adrenal Cortex Hormones