Sjogren's syndrome, cavitating lung disease and high sustained levels of antibodies to serine proteinase 3

A case is described involving Sjogren's syndrome, high sustained levels of antibodies to serine proteinase 3, and cavitating lung disease. Possible di agnoses accounting for this unusual combination include a novel association of Sjogren's syndrome and Wegener's granulomatosis (suggested by the high and sustained levels of antibodies to serine proteinase 3) or a rare presen tation of bronchiolitis obliterans organising pneumonia. Identification of the true nature of the patients illness facilitated more active management and a swift resolution of the clinical problem.