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(A) Chest CT obtained at the onset of SSc shows faint ground glass shadows on both sides of the lung bottom. (B) After six courses of IVCY, no remarkable change was observed. (C) After vaccination, there was an exacerbation of ground glass shadows in the lower lung bilaterally and marked dilation of the oesophagus (arrow)
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Rodnan's skin score (mRSS) was 36/51 points. Respiratory symptoms such as cough and shortness of breath were absent, but chest CT showed interstitial pneumonia in both lungs (Fig. 1A). His skin symptoms gradually improved and the lung lesions did not progress (Fig. 1B). His KL-6 increased to 502 U/ml from 292 U/ml (normal range 105.3-401.2) and chest CT showed ground glass opacities in the lower lobe pleura bilaterally (Fig. 1C).