Introduction: Acute exacerbation of interstitial lung disease (ILD) and COVID-19 pneumonia show many similarities, but also COVID-19 sequelae, mainly when fibrotic features are present, can be difficult to distinguish from chronic ILD observed in connective tissue diseases (CTD). Case report: In 2018, a 52-year-old woman, was diagnosed with pSS. The patient complained of no respiratory symptoms and a chest x-Ray was normal. During March 2020, the patient was hospitalized for acute respiratory failure related to COVID-19 pneumonia. Three months later, follow-up chest HRCT showed ground glass opacity (GGO) and interlobular interstitial thickening. Pulmonary function tests (PFT) showed slight restrictive deficit and mild reduction in diffusion lung of carbon monoxide (DLCO). The patient complained of asthenia and exertional dyspnoea. A multidisciplinary discussion including rheumatologist, pulmonologist, and thoracic radiologist didn’t allow a definitive differential diagnosis between COVID-19 persisting abnormalities and a previous or new-onset pSS-ILD. A wait and see approach was decided, monitoring clinical conditions, PFTs and chest HRCT over time. Only 2 years after the hospitalization, a slight improvement of clinical symptoms was reported; PFT also improved; a follow-up HRCT showed almost complete resolution of GGO and interlobular interstitial thickening, confirming the diagnostic hypothesis of long-COVID lung manifestations. Discussion: In the above-reported case report, 3 differential diagnoses were possible: a COVID-19 related ILD, a pre-existing pSS-ILD or a new-onset pSS-ILD triggered by COVID-19. Regardless of the diagnosis, the persistence of clinical and PFT alterations, suggested a chronic disease but, surprisingly, clinical and radiologic manifestations rapidly disappeared after about 2 years.

Covid-19, a new possible mimicker of interstitial lung disease related to primary Sjögren’s syndrome: a case report / Laneri, Alessia; Cerri, Stefania; DELLA CASA, Giovanni; Moretti, Antonio; Manfredi, Andreina; Sebastiani, Marco; Clini, Enrico; Salvarani, Carlo. - In: CASE REPORTS IN MEDICINE. - ISSN 1687-9635. - 2023:(2023), pp. 1-4. [10.1155/2023/9915553]

Covid-19, a new possible mimicker of interstitial lung disease related to primary Sjögren’s syndrome: a case report.

Alessia Laneri;Stefania Cerri;Giovanni Della Casa;Andreina Manfredi;Marco Sebastiani;Enrico Clini;Carlo Salvarani
2023

Abstract

Introduction: Acute exacerbation of interstitial lung disease (ILD) and COVID-19 pneumonia show many similarities, but also COVID-19 sequelae, mainly when fibrotic features are present, can be difficult to distinguish from chronic ILD observed in connective tissue diseases (CTD). Case report: In 2018, a 52-year-old woman, was diagnosed with pSS. The patient complained of no respiratory symptoms and a chest x-Ray was normal. During March 2020, the patient was hospitalized for acute respiratory failure related to COVID-19 pneumonia. Three months later, follow-up chest HRCT showed ground glass opacity (GGO) and interlobular interstitial thickening. Pulmonary function tests (PFT) showed slight restrictive deficit and mild reduction in diffusion lung of carbon monoxide (DLCO). The patient complained of asthenia and exertional dyspnoea. A multidisciplinary discussion including rheumatologist, pulmonologist, and thoracic radiologist didn’t allow a definitive differential diagnosis between COVID-19 persisting abnormalities and a previous or new-onset pSS-ILD. A wait and see approach was decided, monitoring clinical conditions, PFTs and chest HRCT over time. Only 2 years after the hospitalization, a slight improvement of clinical symptoms was reported; PFT also improved; a follow-up HRCT showed almost complete resolution of GGO and interlobular interstitial thickening, confirming the diagnostic hypothesis of long-COVID lung manifestations. Discussion: In the above-reported case report, 3 differential diagnoses were possible: a COVID-19 related ILD, a pre-existing pSS-ILD or a new-onset pSS-ILD triggered by COVID-19. Regardless of the diagnosis, the persistence of clinical and PFT alterations, suggested a chronic disease but, surprisingly, clinical and radiologic manifestations rapidly disappeared after about 2 years.
2023
2023
1
4
Covid-19, a new possible mimicker of interstitial lung disease related to primary Sjögren’s syndrome: a case report / Laneri, Alessia; Cerri, Stefania; DELLA CASA, Giovanni; Moretti, Antonio; Manfredi, Andreina; Sebastiani, Marco; Clini, Enrico; Salvarani, Carlo. - In: CASE REPORTS IN MEDICINE. - ISSN 1687-9635. - 2023:(2023), pp. 1-4. [10.1155/2023/9915553]
Laneri, Alessia; Cerri, Stefania; DELLA CASA, Giovanni; Moretti, Antonio; Manfredi, Andreina; Sebastiani, Marco; Clini, Enrico; Salvarani, Carlo...espandi
File in questo prodotto:
File Dimensione Formato  
Laneri case report.pdf

Open access

Descrizione: Main text
Tipologia: Versione pubblicata dall'editore
Dimensione 1.28 MB
Formato Adobe PDF
1.28 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1328266
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact