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Inicio Medicina Clínica (English Edition) Pulmonary involvement in Sjögren’s syndrome
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Vol. 158. Issue 4.
Pages 181-185 (February 2022)
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Vol. 158. Issue 4.
Pages 181-185 (February 2022)
Review
Pulmonary involvement in Sjögren’s syndrome
Síndrome de Sjögren y afectación pulmonar
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Jaume Mestre-Torresa,b,
Corresponding author
jmestre@vhebron.net

Corresponding author.
, Roser Solans-Laquea,b
a Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Vall d‘Hebron, Barcelona, Spain
b Departamento de Medicina, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
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Table 1. Classification of pulmonary signs and symptoms according to the Sjogren’s syndrome activity index (ESSDAI) of the European League Against Rheumatism (EULAR).
Abstract

Sjögren’s syndrome is an autoimmune disease that involves exocrine glands. The most characteristic symptoms consist of the sicca syndrome (including xerostomia and dry eye - xerophtalmia), but can involve multiple organs. The extraglandular involvement determines the prognosis. It is tipically associated with the presence of antinuclear antibodies, including Ro-60 antibodies. Pulmonary involvement appears as bronchiectasis and/or interstitial pneumonia. Considering its high prevalence, it must be ruled out in all patients with respiratory symptoms by performing pulmonary function tests and high resolution computed tomography of the chest. Evaluation can be completed with a transbronchial biopsy if diagnostic doubts persist. Treatment includes steroid therapy, inmunosupressive or antifibrotic drugs, or biological therapy. In selected cases pulmonary transplantation must be considered.

Keywords:
Sjögren’s síndrome
Intersitial lung disease
Sicca syndrome
Resumen

El síndrome de Sjögren es una enfermedad autoinmune que afecta a las glándulas exocrinas. Su sintomatología característica es el síndrome seco en forma de xeroftalmia y xerostomía, pero puede afectar a diversos órganos o sistemas, y la afectación extraglandular es la que condiciona el pronóstico de la enfermedad. Típicamente se asocia con la presencia de anticuerpos antinucleares, que incluyen anti-Ro-60. La afectación pulmonar aparece en forma de bronquiectasias y/o neumopatía intersticial. Dada la alta prevalencia de esta complicación, su presencia debe descartarse en todos los pacientes con síntomas respiratorios mediante pruebas de función respiratoria y tomografía computarizada de alta resolución torácica. Se puede completar la valoración mediante biopsia transbronquial en aquellos casos en que existan dudas diagnósticas. El tratamiento incluye glucocorticoterapia, terapia inmunosupresora o antifibrótica, y terapia biológica. En caso de mala evolución se debe valorar el trasplante pulmonar.

Palabras clave:
Síndrome de Sjögren
Enfermedad pulmonar intersticial
Síndrome seco

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