A 52-year-old woman was admitted to our hospital for further examination of blurred vision, abnormal lung shadows and an elevated level of angiotensin-converting enzyme. Sarcoidosis was suspected, however, careful history taking revealed the existence of photosensitivity and polyarthralgia. Laboratory tests showed lymphocytopenia, liver dysfunction, hypergammaglobulinemia, and positive anti-nuclear, anti-double stranded DNA and anti-smooth muscle antibodies. Liver biopsy examination showed

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... ic active hepatitis. She was diagnosed with the triplex of sarcoidosis, systemic lupus erythematosus and autoimmune hepatitis. Marked improvement was noted after corticosteroid therapy. 23: 364-366, 1980. 4. Needleman SW, Silber RA, Von Brecht JH, Goeeken JA. Systemic lupus erythematosus complicated by disseminated sarcoidosis. Report of a case associated with circulating immune complexes. Am J Clin Pathol 78: 105-107, 1982. 5. Aronson PJ, Fretzin DF, Morgan NE. A unique case of sarcoidosis with coexistent collagen vascular disease. Possible result of a compatible disease-sustaining immunologic environment. J Am 2007 The Japanese Society of Internal Medicine