Received:27.11.2025
Accepted:30.12.2025
Published online: 20.03.2026
UDC: 616.24-002.17:616.72-002.77-07-08
DOI: 10.26212/2227-1937.2026.80.80.005
INTERSTITIAL LUNG DISEASE ASSOCIATED WITH SJÖGREN’S SYNDROME: A CLINICAL CASE ILLUSTRATING DIAGNOSTIC CHALLENGES
A.D. Zhadil ¹‚², S.L. Kassenova ¹, N.A. Toktorova ¹
¹ JSC “Scientific Research Institute of Cardiology and Internal Diseases”, Almaty, Kazakhstan
² Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Introduction. Interstitial lung diseases (ILDs) represent a heterogeneous group of more than 200 disorders characterized by inflammation and/or fibrosis of the lung interstitium. Their relevance is determined by the increasing prevalence, challenges of early diagnosis, and significant diversity of clinical manifestations. ILDs associated with connective tissue diseases (CTDs) often complicate the course of the underlying condition and may, in some cases, be its first manifestation.
Objective. To identify the cause of interstitial lung involvement in a young patient and to analyze the clinical features and diagnostic aspects of interstitial lung disease in the context of Sjögren’s syndrome.
Materials and Methods. The patient underwent comprehensive diagnostic evaluation, including immunoblot testing for connective tissue diseases, spirometry with a bronchodilation test, and high-resolution computed tomography (HRCT) of the chest. Treatment and follow-up were carried out in accordance with clinical guidelines. An interdisciplinary consultation involving a pulmonologist and a rheumatologist was conducted to clarify the diagnosis. The patient provided voluntary informed consent for the presentation and publication of this case without disclosure of personal information.
Results. Over the course of one year, the patient experienced recurrent bilateral lung changes that were mistakenly interpreted as pneumonia, and antibacterial therapy proved ineffective. HRCT revealed features consistent with nonspecific interstitial pneumonia (NSIP); restrictive ventilatory defects and a reduced diffusing capacity for carbon monoxide (DLCO) were also noted. Immunological testing demonstrated a positive antinuclear factor (ANF) and antibodies to SS-A. Based on the clinical, instrumental, and laboratory findings, a diagnosis of interstitial lung disease
associated with Sjögren’s disease was established. Baseline therapy was subsequently adjusted.
Discussion. Interstitial lung disease in Sjögren’s disease is associated with significant diagnostic challenges, as pulmonary involvement may represent one of the early manifestations of a rheumatologic condition, highlighting the need for a comprehensive diagnostic evaluation.
Conclusion. This clinical case emphasizes the importance of early interdisciplinary collaboration between a pulmonologist and a rheumatologist, as well as the implementation of immunological screening in patients with unexplained interstitial lung changes and a lack of response to standard antibacterial therapy.
Keywords: interstitial lung disease; Sjögren’s syndrome; nonspecific interstitial pneumonia (NSIP); connective tissue diseases (CTDs); antinuclear factor (ANF); glucocorticosteroids; immunosuppressants.
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