title: Interstitial pneumonia associated with linear immunoglobulin A/immunoglobulin G bullous dermatosis.
abstract: A 76-year-old man with interstitial lung disease was admitted to our institution after developing persistent dyspnea upon effort. He also had a relapse of bullous eruptions on the skin of the trunk and extremities, previously diagnosed as vesicular pemphigoid. Direct immunofluorescence of a skin biopsy specimen using fluorescence microscopy showed the linear deposition of immunglobulin A (IgA), IgG and C3 along the basement membrane. These findings indicated a definitive diagnosis of linear IgA/IgG bullous dermatosis. Chest computed tomography, bronchoalveolar lavage and transbronchial lung biopsy findings suggested nonspecific interstitial pneumonia. Direct immunofluorescence of the lung biopsy specimens using fluorescence microscopy also showed a deposition of IgA, IgG and C3 along the epithelial cell membranes and basement membranes of the bronchioles and alveoli. Lung disorders associated with linear IgA/IgG bullous dermatosis are extremely rare and, to our knowledge, this is the first report of such a case of interstitial pneumonia.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kakugawa
authors.forename: Saori
authors.initials: S
authors.lastname: Tomimura
authors.forename: Tomayoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Noriho
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ishimatsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000368:Aged; D003176:Complement C3 / Q000032:analysis; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D062027:Linear IgA Bullous Dermatosis / Q000150:complications* / Q000276:immunology / Q000473:pathology; D008168:Lung / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000276:immunology / Q000473:pathology; D008297:Male
chemical_list: D003176:Complement C3; D007070:Immunoglobulin A; D007074:Immunoglobulin G