04 May 2025
: Case report 
Refractory Pleuritis in a Patient with Silicosis, Systemic Sclerosis, and Sjögren’s Syndrome: Considering the Potential Role of Adjuvant-Induced Autoimmunity
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare coexistence of disease or pathology
Julia Morimoto ABCDEF 1, Yasuhito Suzuki ABCDEF 1*, Ryuichi Togawa BDE 1, Natsumi Watanabe BDE 1, Takahiro Kumanaka BDE 1, Ryutaro Tanaka BDE 1, Kentaro Kazama BDE 1, Koshi Saito BDE 1, Rina Harigane BDE 1, Ryuki Yamada BDE 1, Riko Sato BDE 1, Hikaru Tomita BDE 1, Takashi Umeda BDE 1, Mami Rikimaru BDE 1, Yuki Sato BDE 1, Hiroyuki Minemura BDE 1, Takefumi Nikaido BDE 1, Junpei Saito
BDEF 1, Kenya Kanazawa B 1, Xintao Wang BDE 1, Yoshinori Tanino BDE 1, Yoko Shibata ABDE 1
DOI: 10.12659/AJCR.947856
Am J Case Rep 2025; 26:e947856
Figure 1 Chest CT on admission showed (A) bilateral multiple nodules with upper-lobe dominance, interlobular septal thickening, and lower-lobe-dominant consolidation with pleural effusion, and (B) mediastinal lymphadenopathy with calcification. Positron emission tomography-CT showed high 18-fluorodeoxyglucose accumulation in the (C) mediastinal lymph nodes (SUV maximum of 5.7), and (D) bilateral pleura (SUV maximum of 5.1). CT – computed tomography; PET – positron emission tomography; SUV – standard uptake value.