case_images: PMC9108358_01
case_images: Imaging features of the patient with both systemic lupus erythematosus (SLE) and Sjogren's syndrome (SS) when she was 5 years old. The textures of both lungs were increased and blurred, and there were small patchy shadows (A). There were 2 small foci of lymphocyte invasion in salivary gland tissue microscopically (>50/focus) after labial gland biopsy (B). (C-E) The volume of the liver was reduced, and each lobe was out of proportion, especially the right lobe. The left and caudal lobes of the liver were enlarged and the fissure was widened. The surface of the liver was not smooth, small nodular protrusions could be seen (shown by arrows), and the density of liver parenchyma was not uniform. The spleen was markedly enlarged and about 6 cm in thickness (shown by arrows).
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case_images: The regular tests of renal function, coagulation, blood lipid, copper protein, ferritin, thyroid function, gastrointestinal barium meal, chest radiograph ( Figure 1A ), and funduscopic examination all showed normal results. Additionally, there were 2 small foci of lymphocyte invasion in salivary gland tissue microscopically (>50/focus) after labial gland biopsy ( Figure 1B ). Figures 1C-E ). Finally, she was diagnosed with SS/SLE and received prednisone and mycophenolate mofetil to treat immunosuppression.
case_images: Pulmonary imaging changes of the patient with systemic lupus erythematosus (SLE)/Sjogren's syndrome (SS) and NMOSD. (A-C) In December 2019, the texture of both lungs was slightly increased and disorganized, and the diffuse distribution of high-density shadows in both lungs was rod-shaped and flaky, some of which were grid-shaped with blurred edges. The cystic transparent shadows could be seen in both upper lungs, no abnormality was observed in the hilar area of both lungs, and multiple enlarged lymph nodes could be seen in the mediastinum. After the anti-infection treatment with meropenem and teicoranin, the exudation of both lungs was significantly reduced 1 month later (D-F), while significant lung interstitial lesions still existed.
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case_images: Lung CT scan showed interstitial lesions and infections in both lungs ( Figure 2 ), while whole exome sequencing (WES) did not detect pathogenic mutations that correlated with clinical manifestations.
case_images: Neuroimaging changes of the patient with systemic lupus erythematosus (SLE)/Sjogren's syndrome (SS) and NMOSD. (A, B) The left optic nerve was obviously smaller than the right through MRI, and there was slight swelling of the spinal cord at the levels of c2-6 (E) in December 2018 (shown by arrows). After a powerful immunosuppressive therapy, the left optic nerve was roughly the same size as the right optic nerve in October 2019 (C, D), and the swelling of c2-6 was much better than before (F).
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case_images: Figures 3A, B ). Furthermore, slight swelling of the cervical spinal cord at c2-6 vertebral levels was detected ( Figure 3E ). Fortunately, the left optic nerve was roughly the same size as the right optic nerve in October 2019 ( Figures 3C, D ), and the swelling was much better than before ( Figure 3F ).