Pulmonary Disease Secondary to Reflux Mimicking Interstitial Pneumonia in Systemic Sclerosis: Case Report and Literature Review.

Ricardo Azêdo De Luca Montes,Pedro Gemal Lanzieri,Luis Otávio Cardoso Mocarzel,Nathalia Mazolli Veiga

doi:10.1155/2016/5926327

Ricardo Azêdo De Luca Montes, Pedro Gemal Lanzieri + Show 2 more

Open Access

https://doi.org/10.1155/2016/5926327

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Abstract

Systemic sclerosis is a complex disease due to the variety of clinical presentations, often superimposed on other conditions, related or not to the connective tissue. We report a 43-year-old Brazilian woman with limited systemic sclerosis and pulmonary symptoms secondary to gastroesophageal reflux disease, with a clinical presentation similar to a diffuse interstitial lung disease. Because of the frequency of interstitial lung injury due to systemic sclerosis, this was an important differential diagnosis, which could be excluded after optimized treatment of reflux disease, with clinical and radiological improvement. Clinical management of patients with collagen diseases requires clinician skills to identify the natural history and understand its nuances. This is a common situation in clinical practice, but with a few discussions in international literature.

Highlights

Systemic sclerosis (SSc) is a syndrome with variable presentation and that can present superimposed on other diffuse connective tissue diseases such as Systemic Lupus Erythematosus (4% of cases), polymyositis, Sjogren’s Syndrome, and Rheumatoid Arthritis [1]
In the case of localized systemic sclerosis, there is a predominance of cutaneous signs, followed in frequency by esophageal dysfunction [3]
There are few reports in the literature that relate the influence of treatment of reflux disease (GERD) to the progression of interstitial lung disease (ILD) [2, 3]

Summary

Introduction

Systemic sclerosis (SSc) is a syndrome with variable presentation and that can present superimposed on other diffuse connective tissue diseases such as Systemic Lupus Erythematosus (4% of cases), polymyositis, Sjogren’s Syndrome, and Rheumatoid Arthritis [1]. Diffuse interstitial lung disease (ILD) is the leading cause of death in the progressive ES with histologic pattern of nonspecific interstitial pneumonia, whose response to immunosuppressive treatment is often unsatisfactory [1,2,3]. In the case of localized systemic sclerosis, there is a predominance of cutaneous signs, followed in frequency by esophageal dysfunction [3]. There are few reports in the literature that relate the influence of treatment of reflux disease (GERD) to the progression of ILD [2, 3]

Case Presentation

Findings

Discussion