Molecular Hydrogen as an Adjuvant Therapy in Comorbid Sjögren's Syndrome, SLE, and ILD: A Case Report on Immune Modulation and Fatigue Reduction.

Abstract

Background/aim: Systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS) are chronic autoimmune diseases that often coexist. They share features such as systemic inflammation and multi-organ involvement and typically require long-term immunosuppressive treatment. However, long-term use of immunosuppressants can cause serious side effects, highlighting the need for adjunct therapies. Molecular hydrogen (H₂) therapy shows anti-inflammatory, antioxidant, and immunomodulatory properties, with potential benefits in liver, lung, and metabolic diseases. This case report examines a patient with overlapping SLE, SS, and interstitial lung disease (ILD), evaluating the effects of molecular hydrogen therapy on fatigue, immune modulation, and cardiac function.

Case report: We present the case of a 69-year-old female diagnosed with Sjögren's syndrome, SLE, and ILD. The patient exhibited chronic symptoms, including xerostomia, xerophthalmia, and respiratory distress, for which she had been receiving corticosteroids and immunomodulatory therapy. Given the persistent disease burden and concerns regarding long-term immunosuppressive therapy, molecular hydrogen therapy was introduced as an adjunctive treatment. Over several months, the patient experienced notable clinical improvements, including resolution of xerostomia, insomnia, dyspnea, chest pain, and dizziness. These symptomatic improvements correlated with favorable immunological shifts in T and B cell subsets, enhanced pulmonary imaging findings, and a reduction in inflammatory markers. Additionally, the patient reported a significant decrease in fatigue, allowing corticosteroid tapering and less reliance on nighttime oxygen. Ongoing hydrogen therapy with high-dose vitamin C maintained disease stability and improved quality of life.

Conclusion: This case highlights the potential of molecular hydrogen (H₂) therapy as a safe, effective adjunct in managing overlapping Sjögren's syndrome, SLE, and ILD. H₂ therapy improved immune profiles and stabilized symptoms in a patient unresponsive to standard treatments.