Primary Sjögren's syndrome accompanied by pleural effusion

A 40-year-old woman was admitted to the hospital because of fever and right cervical pain. Facial erythema developed after admission, along with interstitial shadows and pleural effusion in both lower lung fields. Microscopical examination of transbronchial lung biopsy specimens showed infiltration by lymphocytes and thickening of alveolar walls. Analysis of bronchoalveolar lavage fluid revealed an abnormally high number of cells and CD8 lymphocytes. Schirmer's test and a gum test showed abnormally low lacrimation and salivation. Anti-nuclear antibody, and antibodies against SS-R, and SS-B were present. These findings led to the diagnosis of primary Sjögren's syndrome accompanied by pleural effusion. Facial erythema was regarded as a symptom of Sjögren's syndrome. Prednisolone was given (60 m/day), and the symptoms and the abnormality on the chest roentgenogram resolved within about 1 month.