Drosos A A, Voulgari P V, Psychos D N, Tsifetaki N, Bai M
Department of Internal Medicine, Medical School, University of Ioannina, Greece.
Rheumatol Int. 1999;18(5-6):177-80. doi: 10.1007/s002960050081.
Out of 134, 12 sarcoidosis patients with symptoms of mucosal dryness as the first clinical manifestation were identified and compared with 30 consecutive unselected Sjögren's syndrome (SS) patients. Sicca manifestations were similar among the two groups, while parotid gland enlargement (PGE) was more frequently found in sarcoidosis patients (P < 0.05). Patients with sarcoidosis had mainly pulmonary (P < 0.001) and skin involvement (P < 0.05), while SS patients presented more frequently with Raynaud's phenomenon (P < 0.05). Autoantibody profile was more often found in SS patients compared to sarcoidosis (P < 0.0025). The histopathological findings of minor salivary gland biopsy (MSGB) revealed noncaseating granulomas (NCG) in 58% of patients with sarcoidosis, while in SS, MSGB showed focal sialadenitis in the majority of the patients. Transbronchial lung biopsy (TBLB), which was performed in 10 sarcoidosis patients, revealed the presence of NCG in all patients. In patients with sarcoidosis and sicca symptoms as the presenting syndrome, PGE is a useful clinical finding. Searching for pulmonary involvement is a determining factor to differentiate sarcoidosis from SS. The absence of autoantibodies is another useful tool for the diagnosis of sarcoidosis. Finally, MSGB is very helpful to discriminate between sarcoidosis and SS and when MSGB is not specific, then TBLB is valuable to confirm the diagnosis.
在134例患者中，识别出12例以黏膜干燥症状为首发临床表现的结节病患者，并与30例连续入选的未选择的干燥综合征（SS）患者进行比较。两组的口干眼干表现相似，而结节病患者腮腺肿大（PGE）更为常见（P<0.05）。结节病患者主要有肺部受累（P<0.001）和皮肤受累（P<0.05），而SS患者雷诺现象更为常见（P<0.05）。与结节病患者相比，SS患者自身抗体谱更为常见（P<0.0025）。小唾液腺活检（MSGB）的组织病理学结果显示，58%的结节病患者有非干酪样肉芽肿（NCG），而在SS中，MSGB在大多数患者中显示局灶性涎腺炎。10例结节病患者进行了经支气管肺活检（TBLB），所有患者均发现有NCG。对于以结节病和口干眼干症状为表现综合征的患者，PGE是一项有用的临床发现。寻找肺部受累情况是区分结节病和SS的决定性因素。自身抗体的缺乏是诊断结节病的另一项有用工具。最后，MSGB对鉴别结节病和SS非常有帮助，当MSGB不具有特异性时，TBLB对确诊很有价值。
