CASE PRESENTATION: This is a 58 year old woman with a history of DM, HTN, and anemia presenting with dyspnea on exertion for the past month associated with fatigue, productive cough, light-headedness, and palpitations. One week prior to presentation, she was treated for pneumonia and was informed that she had lung nodules. She never smoked tobacco, emigrated from Jamaica in 1979, and completed treatment for a positive skin tuberculin test in 1999. Review of systems revealed Raynaud’s phenomenon, dry eyes, and dry mouth. Bronchoalveolar lavage showed a lymphocytic predominance (46%). Inflammatory work up revealed elevated ESR and CRP, a positive ANA with speckled pattern, and elevated anti-SS-A and anti-SS-B. CT-guided lung biopsy was consistent with lymphocytic interstitial pneumonia. The patient was diagnosed with SLE and secondary Sjogren’s syndrome. She was treated with systemic corticosteroids and cyclophosphamide.