A case of sine scleroderma with parenchymal lung disease

Authors
Mansoor Karimifar
Hourosadat Hashemi
Mozhgan Karimifar
Amir Kazizadeh
Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Soffe Avenue, Isfahan, Iran
Abstract
Systemic sclerosis sine scleroderma is a subtype of scleroderma, which is characterized by involvement of visceral organs, but no characteristic skin alteration. The involved organs could be kidneys, heart, gastrointestinal system, and lungs. Interstitial lung disease (ILD) is one of the pulmonary manifestations of sine scleroderma. We report a 38-year-old woman presenting with chill, fever, generalized malaise, dyspnea on exertion, and dry cough with a history of Raynaud's phenomenon, who was evaluated by physical examination, spirometry, and computed tomography scan, that all lead to the diagnosis of ILD. Combination of high-titer positive anti-nuclear antibody, high erythrocyte sedimentation rate, positive C-reactive protein, and ILD could be explained by sine scleroderma.

Keywords

1. Kreig T, Takehara K. Skin disease: A cardinal feature of systemic sclerosis. Rheumatology (Oxford) 2009;48(Suppl 3):iii14-8.  Back to cited text no. 1
    
2. Toya SP, Tzelepis GE. The many faces of scleroderma sine scleroderma: A literature review focusing on cardiopulmonary complications. Rheumatol Int 2009;29:861-8.  Back to cited text no. 2
[PUBMED]    
3. Fischer A, Meehan RT, Feghali-Bostwick CA, West SG, Brown KK. Unique characteristics of systemic sclerosis sine scleroderma-associated interstitial lung disease. Chest 2006;130;976-81.  Back to cited text no. 3
    
4. Raghu G, Brown KK. Interstitial lung disease: Clinical evaluation and keys to an accurate diagnosis. Clin Chest Med 2004;25:409-19.  Back to cited text no. 4
[PUBMED]    
5. Poormoghim H, Lucas M, Fertig N, Medsger TA Jr. Systemic sclerosis sine scleroderma: Demographic, clinical, and serologic features and survival in forty-eight patients. Arthritis Rheum 2000;43:444-51.  Back to cited text no. 5
[PUBMED]    
6. Strange C, Highland KB. Interstitial lung disease in the patient who has connective tissue disease. Clin Chest Med 2004;25:549-59.  Back to cited text no. 6
[PUBMED]    
7. Ferri C, Bernini L, Gremignai G, Latorraca A, Fazzi P, Tavon A, et al. Lung involvement in systemic sclerosis sine scleroderma treated by plasma exchange. Int J Artif Organs 1992;15:426-31.  Back to cited text no. 7
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Advanced Biomedical Research
Volume 2014, January
January 2014
Pages 1-2