• Internal medicine · Feb 2022

    Case Reports

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

    • Masafumi Shimoda, Yoshiaki Tanaka, Kozo Morimoto, Kiyomi Shimoda, Tamiko Takemura, Teruaki Oka, Takashi Yoshiyama, Kozo Yoshimori, and Ken Ohta.
    • Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan.
    • Intern. Med. 2022 Feb 15; 61 (4): 517-521.

    AbstractAn 84-year-old woman visited our hospital for dyspnea due to right pleural effusion, with lymphocytic dominance and a high adenosine deaminase (ADA) level, that had been noted 1 month earlier. She was suspected of having tuberculosis pleurisy; however, anti-tuberculosis treatment yielded no improvements. She was diagnosed with pleural effusion due to primary Sjögren's syndrome (SjS) based on her dry eyes and mouth, positivity for anti-Sjögren's-syndrome-related antigen A/B, and histopathologic findings of a lip biopsy and thoracoscopic pleural biopsy. Her symptoms improved after starting steroid therapy. Cases of pleural effusion due to SjS with a high ADA level may be misdiagnosed as tuberculosis pleurisy.

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