A 44-yr-old man with dyspnea (ATS Gr II) Ex smoker 1 * 24 pack years, 1 년전 quit 1 년전부터 dyspnea 발생 당시 PFT : no abnormality 8 개월 전 모 대학병원에서 시행한 건강검진상 이상소견.

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A 44-yr-old man with dyspnea (ATS Gr II) Ex smoker 1 * 24 pack years, 1 년전 quit 1 년전부터 dyspnea 발생 당시 PFT : no abnormality 8 개월 전 모 대학병원에서 시행한 건강검진상 이상소견 없다고 들음 6 개월 전 CAG 시행상 이상소견 없다고 들음 (local H) 부정맥 (?) medication 15 일 정도후 medication stop 3 개월 전부터 본원 IM3 OPD 내원 CT 상 양쪽 폐에 lung 에 GGO 보임. * CEA 17.3, FEV1 75% FVC 2.81(66%) 직업 : 공무원 체중감소 : 13kg(76 -> 63)/1years Arthralgia: both knee, ankle Muscle weakness; Both lower extremity

Progression Note PFT- FVC 2.8(68) FEV1 2.29(69) FEV1/FVC 78% --> mild restrictive pattern BAL: monocyte dominant(86%) VAT’s lung biopsy 시행 RF 85.1, FANA 2+, anti-Ro/SSA +(>200), Anti-CCP 로 협진 결과 Sjogren's SD 및 RA 에 대한 lung 이외의 증상 뚜렷하지 않아 lung lesion 치료가 우선이며, Sjogren's SD 에 대해서는 예방적으로 HCQ 200mg bid 시작하기로 함. Initial CEA 12.2 로 elevation, weight loss 있어 hidden malignancy 가 능성 있어 APCT 시행하였으나, 이상소견 보이지 않았고, 연고지 병원 에서 EGD, colonoscopy 시행하기로 하고 퇴원함.

Diffuse ground-glass opacities in both lungs with lower lobe predominancy

Diffuse ground-glass opacities in both lungs

Lung involvement of Sjogren’s syndorme, NSIP pattern Interstitial inflammation and fibrosis, slightly bronchiolocentric accentuation, relatively even disease age

Lung involvement of Sjogren’s syndorme, NSIP pattern Interstitial inflammation and fibrosis, slightly bronchiolocentric accentuation, relatively even disease age

Lung involvement of Sjogren’s syndorme, NSIP pattern Interstitial inflammation and fibrosis, slightly bronchiolocentric accentuation, relatively even disease age

Lung involvement of Sjogren’s syndorme, NSIP pattern