Systemic Sclerosis with Interstitial Lung Disease: A Case Report

Background: A 45 -year -old female presented with breathlessness (MMRC grade 2), fatigue, and generalized myalgia for 10 days.Initial investigations indicated normocytic hypochromic anemia, elevated ESR and CRP levels, moderate pleural effusion on 2D echocardiography, and subpleural fibrosis with ground -glass opacities on HRCT. Cardiology and pulmonology consultations suggested the possibility of interstitial lung disease (ILD). Given the suspected systemic autoimmune involvement, rheumatology and ophthalmology evaluations were conducted, leading to further diagnostic testing. Method: A comprehensive diagnostic workup included blood tests, imaging studies, and specialist consultations. Hemoglobin levels were measured, and a peripheral blood smear was analyzed. ESR and CRP levels were assessed to determine inflammation. Echocardiography and HRCT were performed to evaluate cardiac and pulmonary involvement. Ophthalmological examination included Schirmer's test for Sjögren's syndrome. Rheumatological evaluation involved ANA with ANA profile, LDH, and serum ferritin measurements. Results: The patient was found to have normocytic hypochromic anemia (Hb: 9.9), elevated ESR (71), and CRP (9.6). Echocardiography revealed moderate pleural effusion and a normal ejection fraction (65%). HRCT showed subpleural fibrosis and ground -glass opacities. Schirmer's test for Sjögren's syndrome was negative. Rheumatological tests revealed positive ANA with a cytoplasmic pattern and SSA/Ro -52kD antibodies, elevated LDH (457), and serum ferritin (617). The patient was diagnosed with systemic sclerosis with ILD. Conclusion: The patient was treated with corticosteroids, immunosuppressive agents, calcium supplements, antivertigo medications, and other supportive treatments, resulting in symptomatic improvement. This case highlights the importance of a multidisciplinary approach in diagnosing and managing systemic sclerosis with ILD.