Sjögren's syndrome, cavitating lung disease and high sustained levels of antibodies to serine proteinase 3.
A case is described involving Sjögren's syndrome, high sustained levels of antibodies to serine proteinase 3, and cavitating lung disease. Possible diagnoses accounting for this unusual combination include a novel association of Sjögren's syndrome and Wegener's granulomatosis (suggested by the high and sustained levels of antibodies to serine proteinase 3) or a rare presentation of bronchiolitis obliterans organising pneumonia. Identification of the true nature of the patients illness facilitated more active management and a swift resolution of the clinical problem.
Young
C
C
Department of Rheumatology, Royal Free Hospital, London, UK. charles.young@ic.ac.uk
Hunt
S
S
Watkinson
A
A
Beynon
H
H
D000368:Aged; D000900:Anti-Bacterial Agents; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D018549:Cryptogenic Organizing Pneumonia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D013902:Radiography, Thoracic; D012697:Serine Endopeptidases / Q000276:immunology*; D012859:Sjogren's Syndrome / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D012697:Serine Endopeptidases