Salazosulfapyridine-induced eosinophilic pneumonia with pulmonary and cutaneous epithelioid cell granulomatosis in Sjögren syndrome

A 68-year old woman suffering from Sjögren's syndrome for the last 30 years took sulphasalazine (SSP) for severe signs and symptoms at the joints. Soon after the start of this medication she developed progressive cough and shortness of breath. After two years she was referred for evaluation of...

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Bibliographic Details
Published inPneumologie (Stuttgart, Germany) Vol. 44; no. 4; p. 744
Main Authors Bargon, J, Rust, M, Kardos, P, Schneider, M, Meier-Sydow, J
Format Journal Article
LanguageGerman
Published Germany 01.04.1990
Subjects
Aged
Female
Granuloma - chemically induced
Humans
Pulmonary Eosinophilia - chemically induced
Sjogren's Syndrome - drug therapy
Skin Diseases - chemically induced
Sulfasalazine - administration & dosage
Sulfasalazine - adverse effects
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Summary:A 68-year old woman suffering from Sjögren's syndrome for the last 30 years took sulphasalazine (SSP) for severe signs and symptoms at the joints. Soon after the start of this medication she developed progressive cough and shortness of breath. After two years she was referred for evaluation of a hemoptysis and a reddish skin lesion. The chest radiograph showed wide spread interstitial infiltrates in the lower lobes and some fibrotic changes. FVC was slightly reduced, DLCO markedly reduced. There was a high percentage of eosinophils in the bronchoalveolar lavage (55.2%). Transbronchial lung biopsy and skin biopsy demonstrated epitheloid granulomata. SSP was discontinued. After a short period of prednisone treatment the patient's condition improved considerably. After two months of followup neither pulmonary infiltrates nor any skin lesions were found. History and the clinical course after discontinuation of SSP indicate the relation of these infiltrates to SSP treatment. The previously published case reports of SSP-related lung disorders are reviewed. Three of these case reports included bronchoalveolar lavage. Our data suggest that patients with SSP related pulmonary infiltrates may have a marked increase of eosinophils in the bronchoalveolar lavage fluid.
ISSN:0934-8387