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Case Reports in Rheumatology
Volume 2017, Article ID 7851652, 4 pages
https://doi.org/10.1155/2017/7851652
Case Report

Sarcoidosis and Systemic Sclerosis: Strange Bedfellows

1Department of Medicine, Loma Linda University, Loma Linda, CA, USA
2Division of Rheumatology, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
3Division of Pulmonary and Critical Care, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
4Department of Radiology, Loma Linda University, Loma Linda, CA, USA

Correspondence should be addressed to Micah Yu; ude.ull@uycim

Received 2 June 2017; Accepted 27 July 2017; Published 24 August 2017

Academic Editor: Tsai-Ching Hsu

Copyright © 2017 Micah Yu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Coexistence of systemic sclerosis and sarcoidosis is rare. Both have predominant lung manifestations, each with distinctive features on computed tomography (CT) of the chest. We present herein a 52-year-old male with limited systemic sclerosis manifested primarily by sclerodactyly and subsequently by shortness of breath. A series of CT scans of the chest were reviewed. Initial CT chest one year prior to sclerodactyly onset revealed bilateral hilar and right paratracheal, prevascular, and subcarinal adenopathy. Five-year follow-up demonstrated thin-walled cysts, mediastinal lymphadenopathy, and nonspecific nodules. Due to progression of dyspnea, follow-up CT chest after one year again demonstrated multiple cysts with peripheral nodularity and subpleural nodules, but no longer with hilar or mediastinal adenopathy. Diagnostic open lung biopsy was significant for noncaseating granulomas suggestive of sarcoidosis. This is the first known case of a patient with systemic sclerosis diagnosed with sarcoidosis through lung biopsy without radiographic evidence of hilar or mediastinal lymphadenopathy at the time of biopsy. A review of cases of concomitant sarcoidosis and systemic sclerosis is discussed, including the pathophysiology of each disease with shared pathways leading to the development of both conditions in one patient.