#5-31E. Decoupling Cysts and Lung Function: Understanding Sjögren’s LIP Phenotype (Rheumatology, 2026)

When managing interstitial lung disease in Sjögren disease, does radiological worsening of cysts dictate a change in clinical therapy? This retrospective, single-center study analyzed fifty-five patients with Sjögren disease-associated interstitial lung disease, including eleven diagnosed with lymphoid interstitial pneumonia, to characterize their clinical course over a median five-year follow-up. While thin-walled parenchymal cysts on high-resolution CT progressed in number and size, pulmonary function remained remarkably stable in these patients. The landmark finding of this study is the distinct dissociation between radiologic cyst progression and stable lung function, showing that anatomic damage accrual does not necessarily translate to functional decline. However, when critically appraising these findings, clinicians must consider the study's retrospective design and the extremely limited cohort size of only eleven lymphoid interstitial pneumonia patients, which restricts its generalizability. Ultimately, this research suggests that treatment decisions should rely on respiratory symptoms and systemic disease activity rather than isolated radiographic progression, preventing unnecessary immunosuppressive escalation.

Citation: Gaetano La Rocca, Francesco Ferro, Vincenzo Uggenti, Beatrice Dei, Giovanni Fulvio, Michele Moretti, Riccardo Morganti, Gianluca Sambataro, Marta Mosca, Chiara Romei, Chiara Baldini. Lymphoid interstitial pneumonia in Sjögren disease: clinical course and comparison with other ILD patterns. Rheumatology. 2026. DOI: 10.1093/rheumatology/keag321 URL: https://doi.org/10.1093/rheumatology/keag321

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