A case of primary Sjögren’s syndrome with pleural effusion, pericardial effusion and ascites

Abstract

Sjögren’s syndrome (SS) is an autoimmune disease with glandular and extraglandular manifestations. In terms of pulmonary and cardiac involvement, pleural and pericardial effusion are rare. We report a case of primary SS (pSS) presenting as pleural effusion, pericardial effusion and ascites. A 58-year-old woman was admitted to our hospital with a 2-week history of dyspnea. Bilateral pleural effusion, pericardial effusion and ascites were detected. Primary SS was diagnosed, based on xerophthalmia, xerostomia, positive results for the Shirmer test and anti-SS-A antibody, and abnormal salivary gland sialography. Pleural and pericardial effusion attributed to autoimmunological inflammation and ascites was thought to be due to severe hypoalbuminemia. Treatment with high-dose corticosteroid proved successful.

Keywords

• Sjögren’s syndrome
• pleural effusion
• pericardial effusion
• ascites
• polyserositis

Kaynakça

1. Inokuma S. Pulmonary involvement in Sjögren's syndrome. Intern Med 2002; 41: 73-74.
2. Lin DF, Yan SM, Zhao Y, et al. Clinical and prognostic characteristics of 573 cases of primary Sjogren’s syndrome. Chin Med J 2010; 123: 325332
3. Soliotis F, Kassan S, Movtsopoulos H. The internal organs in Sjogren’s. In: Carsons S, Harris EK, editors. The new Sjogren’s syndrome handbook. 3rd ed. New York: Oxford University Press: 2005. p 68-80.
4. Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjögren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61: 554-558.
5. Papathanasiou MP, Constantopoulos SH, Tsampoulas C, Drosos AA, Moutsopoulos HM. Reappraisal of respiratory abnormalities in primary and secondary Sjögren's syndrome. A controlled study. Chest 1986; 90: 370-374.
6. Rajani AR, Hussain K, Baslaib FO, Rao KN. An unexpected diagnosis in a dyspnoeic patient with primary Sjogren syndrome. BMJ Case Rep 2013. pii: bcr2012007819. doi: 10.1136/bcr-2012-007819.
7. Vassiliou VA, Moyssakis I, Boki KA, Moutsopoulos HM. Is the heart affected in primary Sjögren's syndrome? An echocardiographic study. Clin Exp Rheumatol 2008; 26: 109-112.
8. Mutsukura K, Nakamura H, Iwanaga N, Ida H, Kawakami A, Origuchi T, et al. Successful treatment of a patient with primary Sjögren’s syndrome complicated with pericarditis during pregnancy. Intern Med 2007; DOI: 10.2169/internalmedicine.46.0062.

9. Suzuki H, Hickling P, Lyons CB. A case of primary Sjögren's syndrome, complicated by cryoglobulinaemic glomerulonephritis, pericardial and pleural effusions. Br J Rheumatol 1996; 35: 72-75.
10. Ogihara T, Nakatani A, Ito H, et al. Sjögren's syndrome with pleural effusion. Intern Med 1995; 34: 811-8
11. Makimoto G, Asano M, Fujimoto N, et al. Bilateral pleural effusions as an initial presentation in primary Sjögren’s syndrome. Case Rep Rheumatol 2012; DOI: 1155/2012/640353.