Type II Diabetes Mellitus and Primary Sjoegren's Syndrome Complicated by Pleural Effusion.

Abstract

A 73-year-old manwas admitted to our hospital because of pleural effusion and nephrotic syndrome. Sjogren's syndrome (Sjs) was diagnosed based on a positive test for antibodies to Ro and La, and the result of labial salivary gland biopsy. The pleural effusion showed a high number of lymphocytes and high titers of antibodies to Ro and La. By immunohistochemistry, it was determined that infiltrating CD3+ cells predominated over infiltrating CD20+cells in the pleura. Nephrotic syndromewasalso present, which, as confirmed by renal biopsy was due to advanced diabetic nephropathy. Here, wereport a case of Type II diabetes mellitus and primary Sjs complicated by pleural effusion, discuss the available treatment for pleural effusion. (Internal Medicine 39: 979-984, 2000)

Pulmonary Manifestations of Sjögren’s Syndrome

“…There have only been nine previous reports in the literature of pleural effusion occurring as a specific complication of primary SS (61–67)(68). Pleural fluid in these cases was characterized by lymphocytosis, elevated levels of SS-A/SS-B antibodies, and low complement levels.…”

Sjögren's Syndrome with Pleural Effusion: Difficult to Distinguish from Tuberculous Pleurisy Because of a High Adenosine Deaminase Level

“…There have been 12 other case reports of primary SjS with pleural effusion, which are shown in Table (5,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”

Pleuritis associated with primary Sjogren syndrome

“…In fact, a previous study reported that no pleural effusion was observed in 40 cases of primary SjS, although it was observed in 2 of 26 cases (8%) of secondary SjS [2]. To our knowledge, there have been 11 reported cases of primary SjS complicated by pleuritis [3][4][5][6][7][8][9][10][11][12][13] (Table 1). Among them, only three patients developed pleural effusion during the clinical course, whereas the remaining eight were diagnosed simultaneously with primary SjS and pleural effusion.…”