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We report a rare case of interstitial lung disease as the first clinical manifestation of primary SjÃ¶grenâ€™s syndrome. A 49-year-old woman was assessed, complaining of dyspnea, dry cough, dry mouth, inflamed right cheek, dry skin, bilateral gastrocnemius pain, multiple peripheral arthralgia, and generalized weakness for the previous 2 months. Serology examination was positive for SjÃ¶grenâ€™s syndrome antibodies. Thorax CT demonstrated Crazy Paving appearance. Glucocorticoid alone did not improve the respiratory symptoms, hence azathioprine was given. Subsequent dyspnea regression and disease control obtained after 5 months of therapy. This case demonstrated that ILD could be the first clinical manifestation in pSS, and azathioprine could be used as the first line therapy for SjÃ¶grenâ€™s syndrome-related lung disease.
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