Analysis of Non-TB Mycobacterial Lung Disease in Patients With Primary Sjögren’s Syndrome at a Referral Center

Abstract

Primary Sjögren's syndrome (pSS) may be complicated by various lung diseases including bronchiectasis, which is a known risk factor for non-TB mycobacterial lung disease (NTM-LD). 1 Previous studies associating pSS with NTM-LD were either a case report 2 or a small case series 3 or relied on a health insurance claims database with no patient details. 4 Thus, we retrospectively characterized the clinical, radiographic, and microbiologic features of a relatively large group of patients with pSS with and without NTM-LD. Patients and MethodsAfter Institutional Review Board approval, individuals with a positive anti-SS-A antibody test between 2008 and 2018 at National Jewish Health (NJH) were identified by dataSCOUT (DataScout LLC, Fayetteville, AR), an automated search of electronic medical records. The algorithm for subsequent analyses is shown in Figure 1. The diagnosis of NTM-LD was based on a consensus publication. 5 Demographic information, underlying medical conditions, use of glucocorticoid and diseasemodifying anti-rheumatic drugs (DMARDs) prior to first diagnosis of NTM-LD, and NTM microbiologic data were tabulated from the first visit to NJH. All available sputum culture results after antibiotic and surgical treatment were charted. The frequency of four chest CT findings (bronchiolitis, bronchiectasis, consolidation, and cavitation) were recorded for patients with NTM-LD who were infected with a single NTM species.

Manifestations and management of Sjögren’s disease

“…Airflow limitation due to these Sjögren’s-associated airway diseases, especially with significant reversibility with bronchodilators and/or glucocorticoids, may resemble asthma [ 51 ]. Superimposed lung disease due to non-tuberculous mycobacteria is not uncommon [ 53 ]. ILD may lead to pulmonary fibrosis.…”