title: Concomitant Systemic Sclerosis and Sarcoidosis with Combined Pulmonary Fibrosis and Emphysema.
abstract: A 75-year-old woman was referred to our hospital with the chief symptom of dyspnea. Chest computed tomography revealed lymphadenopathy, emphysema, and honeycombing. Sarcoidosis was diagnosed due to an elevated serum ACE level and the findings of a lymph-node biopsy. Her smoking history, radiography findings, and impaired gas exchange indicated combined pulmonary fibrosis and emphysema (CPFE). Raynaud's phenomenon gradually appeared, and we also diagnosed her with systemic sclerosis (SSc). Right heart catheterization revealed pulmonary hypertension (PH). Smoking was assumed to be the chief cause, but SSc may also induce the development of CPFE. Severe PH induced by CPFE or SSc was present, but the influence of sarcoidosis also could not be ignored.
authors.affiliation: Department of Respiratory Medicine, Saiseikai Suita Hospital, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Koguchi
authors.forename: Asuka
authors.initials: A
authors.lastname: Okada
authors.forename: Sumito
authors.initials: S
authors.lastname: Choh
authors.forename: Kumiko
authors.initials: K
authors.lastname: Katayama
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takenaka
authors.forename: Koichi
authors.initials: K
authors.lastname: Tomoda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
mesh_terms: D000368:Aged; D001706:Biopsy; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D011656:Pulmonary Emphysema / Q000150:complications*; D011658:Pulmonary Fibrosis / Q000150:complications* / Q000473:pathology; D012507:Sarcoidosis / Q000150:complications*; D012595:Scleroderma, Systemic / Q000150:complications*; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed