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; Ken Ohta

doi:10.2169/internalmedicine.7818-21

This article has now been updated. Please use the final version.

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, Ken Ohta

Author information

Masafumi Shimoda
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan
Yoshiaki Tanaka
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan
Kozo Morimoto
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan
Kiyomi Shimoda
Department of Thoracic Surgery, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan
Tamiko Takemura
Department of Pathology, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan
Teruaki Oka
Department of Pathology, Kanagawa Cardiovascular and Respiratory Center, Japan
Takashi Yoshiyama
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan
Kozo Yoshimori
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan
Ken Ohta
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan

Keywords: Sjögren's syndrome, pleural effusion, adenosine deaminase, tuberculous pleurisy

JOURNAL OPEN ACCESS Advance online publication

Article ID: 7818-21

DOI https://doi.org/10.2169/internalmedicine.7818-21

The final version of this article is now available: Vol. 61 (2022), No. 4 pp. 517-521

Details

Abstract

An 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.

Corresponding author

Register with J-STAGE for free!