Journal List > Tuberc Respir Dis > v.65(4) > 1001290

Kwon, Hong, Lim, Park, Bae, Kim, Choi, Mo, and Park: Systemic Lupus Erythematosus Associated with Interstitial Pneumonia and Achalasia

Abstract

Systemic lupus erythematosus (SLE) is a multisystem disorder where the etiology is not clearly known. Symptomatic chronic interstitial pneumonitis is an uncommon manifestation, with a reported prevalence of 3~13%. Achalasia is rare disease that presents with failure in the relaxation of the esophagus sphincter. A 22-year-old woman was admitted to our hospital because of fever, cough and dyspnea. The patient had a history of pericardial effusion and Raynaud's phenomenon. The results of laboratory tests indicated the presence of lymphopenia and included positive antibody tests for antinuclear antibody and anti Sm antibody. A chest X-ray demonstrated the presence of peribronchial infiltration on both lung fields. A Chest CT image showed interlobar septal thickening, ground-glass opacity and a honeycomb appearance in both lung fields and esophageal dilatation with air fluid level. An esophagogram showed the presence of dilated esophagus ends that represented the non-relaxed lower esophageal sphincter. Manometry demonstrated incomplete sphincter relaxation. The case was diagnosed as systemic lupus erythematosus associated with interstitial pneumonia and achalasia.

Figures and Tables

Figure 1
Chest PA shows diffuse reticularities with peribronchial infiltration on both lower lung fields.
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Figure 2
HRCT scan shows interlobular septal thickening, ground glass opacity and honeycomb appearance on right upper lung and both lower lungs.
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Figure 3
(A) Chest CT shows dilated middle and lower esophagus which filled with food. (B) Barium esophagography shows that lower esophageal sphincter dose not relax normally and the esophageal body undergoes nonperistaltic contraction.
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