[A case of Sjögren's syndrome with lymphocytic interstitial pneumonia]

A 73-year-old woman was admitted to our hospital in January 1995 because of dry cough and dyspnea. A diagnosis of primary Sjögren's syndrome with distal renal tubular acidosis and Hashimoto's disease had been made in 1984. Dry cough developed and a chest X-ray showed bilateral reticulo-nodular shadows in the lower lung field in 1992. Her symptoms had gradually became more severe and the reticulo-nodular shadows on her chest X-ray had spread to both upper lung fields. We performed transbronchial lung biopsy. Biopsy specimens showed lymphocytic infiltration of the aleveolar walls. These lymphocytes were almost CD3-positive and CD19-negative in immunohistopathological studies. CD4-positive cells and CD8-positive cells were present in almost equal numbers. A diagnosis of lymphocytic interstitial pneumonia (LIP) associated with Sjögren's syndrome was made. The patient was treated with prednisolone, 40 mg daily. Her dry cough and dyspnea improved slightly but her chest X-ray remained unchanged. We suggest that immunohistopathological analysis of biopsy specimens may show a difference between lymphocytic infiltration of labial salivary glands and of the lung.