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Comment on Autoimmune Pathogenesis

Arnold I. Levinson, MD; Philip C. Hopewell, MD; Daniel P. Stites, MD; Lynn E. Spitler, MD; H. Hugh Fudenberg, MD

Arch Intern Med. 1976;136(2):213-216.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The coexistence of lymphoid interstitial pneumonia, pernicious anemia and common variable hypogammaglobulinemia represents a disease triad not previously described. However, both pernicious anemia and lymphoid interstitial pneumonia have been independently associated with dysproteinemia,^1-4 and both have features that tend to implicate immunologic alterations in their pathogenesis. The occurrence of these diseases in the same patient stimulated extensive evaluation of her immune system.

PATIENT SUMMARY

A 58-year-old woman was found to have pernicious anemia in 1960. The diagnosis was based on the findings of macrocytic red blood cell (RBC) indices, a megaloblastic bone marrow specimen, histamine-fast achlorhydria, abnormal Schilling test results, and correction of the anemia by vitamin B₁₂. A chest roentgenogram showed middle lobe and lingular infiltrate characterized by "honeycombing" and also bilateral pleural thickening. At that time, her only pulmonary symptom was a mild dry cough. However, over the next several years she developed increasing dyspnea, and . . . [Full Text PDF of this Article]

Author Affiliations
From the Section of Immunology, University of California, School of Medicine, San Francisco (Drs Levinson, Stites, Spitler, and Fudenberg), and the Chest Service, San Francisco General Hospital (Dr Hopewell).

Footnotes
Received for publication Jan 24, 1975; accepted April 30.

Reprint requests to Box 433, Walter Reed Army Medical Center, Washington, DC 20014 (Dr Levinson).

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