| 中文摘要 |
A 68-year-old lady suffered from progressive dysphagia for several years. She had significant anorexia and weight loss of around 8 kg in three years. Dyspnea, chest tightness, weakness, myalgia and tongue pain were also reported. History of acute pancreatitis was diagnosed due to elevation of amylase and lipase, and CT image of ill-defined peripancreatic inflammation and fluid collections. Significant esophageal wall thickening (arrow) with proximal lumen dilatation was revealed by CT scan (Fig. 1a).Chest X ray revealed interstitial lung fibrosis. Autoimmune disorder was suspected due to multiple organ involvement. Lab data revealed 1+ urine proteinuria, cortisol level less than 1.0 ug/dL (at 8 am), negative serum protein electrophoresis, IgG4 level, thyroid stimulating hormone, antinuclear antibody, SS-A, SS-B, Scl-70 antibody, anti-RNP antibody, C3, C4, and low voltage in EKG. |
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