{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T16:36:33Z","timestamp":1772642193506,"version":"3.50.1"},"reference-count":15,"publisher":"Pensoft Publishers","issue":"1","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>Sj\u00f6gren\u2019s syndrome (SS) is a chronic autoimmune disorder primarily affecting exocrine glands, characterized by dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca). However, systemic manifestations, including pulmonary complications, are increasingly recognized. Diffuse alveolar hemorrhage (DAH) is a rare but life-threatening presentation of SS, typically associated with vasculitis or coagulation abnormalities. We report the case of a 19-year-old male presenting with dyspnea and hemoptysis, later diagnosed with primary Sj\u00f6gren\u2019s syndrome (pSS). Initial clinical assessment revealed respiratory failure with low blood oxygen levels (hypoxemia), bilateral ground-glass opacities on chest computed tomography (CT), and iron-storing macrophages (hemosiderin-laden) in bronchoalveolar lavage fluid, consistent with DAH. Subsequent autoimmune serology confirmed positivity for anti-Ro\/Sj\u00f6gren\u2019s-syndrome-related antigen A autoantibodies (SSA) and anti-La\/Sj\u00f6gren\u2019s-syndrome-related antigen B autoantibodies (SSB), while other autoimmune markers, including anti-neutrophil cytoplasmic antibodies (ANCA), were negative. Labial salivary gland biopsy demonstrated focal lymphocytic sialadenitis, confirming pSS according to European League Against Rheumatism (EULAR) criteria. Treatment involved high-dose corticosteroids, leading to complete resolution of symptoms and significant improvement in imaging results. The patient remained stable at follow-up. DAH should be considered a potential presentation of pSS, even in the absence of classical symptoms. Increased awareness of this rare complication can facilitate early diagnosis and improve outcomes.<\/jats:p>","DOI":"10.3897\/folmed.68.e147318","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T11:58:28Z","timestamp":1772625508000},"source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary hemorrhage as a first manifestation of Sj\u00f6gren\u2019s disease in a young male adult"],"prefix":"10.3897","volume":"68","author":[{"given":"Konstantinos","family":"Dodos","sequence":"first","affiliation":[{"name":"Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsampika Vasileia","family":"Kalamara","sequence":"additional","affiliation":[{"name":"Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-811X","authenticated-orcid":true,"given":"Vasiliki Epameinondas","family":"Georgakopoulou","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"147318_B1"},{"key":"147318_B2"},{"key":"147318_B3","unstructured":"Carsons SE, Patel BC. Sjogren syndrome. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan\u2013."},{"key":"147318_B4"},{"key":"147318_B5"},{"key":"147318_B6"},{"key":"147318_B7"},{"key":"147318_B8"},{"key":"147318_B9"},{"key":"147318_B10"},{"key":"147318_B11"},{"key":"147318_B12","doi-asserted-by":"crossref","unstructured":"Parimi VP, Rajasekhar L. Primary Sjogren syndrome with diffuse alveolar hemorrhage, cryoglobulinaemia and thrombotic microangiopathy. J Med Sci Res 2016; 4(1):26\u20137.","DOI":"10.17727\/JMSR.2016\/4-008"},{"key":"147318_B13","unstructured":"Yagyua K, Kojimaa K, Okaa T, et al. A case of Sj\u00f6gren syndrome complicated by ANCA-related diffuse alveolar hemorrhage and antiphospholipid syndrome. AJRS 2017; 6(5):383\u20138."},{"key":"147318_B14"},{"key":"147318_B15"}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/147318\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/147318\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=147318&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T11:58:29Z","timestamp":1772625509000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/147318\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2,26]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.68.e147318","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,26]]},"article-number":"e147318"}}