Matsuda Masayuki, Hamano Hideaki, Yoshida Takuhiro, Gono Takahisa, Uehara Takeshi, Kawa Shigeyuki, Ikeda Shu-ichi
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Asahi, Matsumoto, Japan.
Clin Rheumatol. 2007 Jan;26(1):117-9. doi: 10.1007/s10067-005-0119-8. Epub 2005 Dec 15.
We report two elderly patients with seronegative Sjögren syndrome who showed benign swelling of the pancreas on computed tomography. Immunostaining of the biopsied lip tissue or serum examination confirmed an increase in production of IgG4, leading to a diagnosis of autoimmune sclerosing pancreatitis (ASP) as a cause of the asymptomatic swelling of the pancreas. Sicca symptoms and ASP spontaneously improved in one patient, and the other responded well to oral prednisolone. Seronegative Sjögren syndrome and ASP can concurrently occur as a clinical manifestation of the IgG4-related systemic disorder, particularly in elderly subjects, and, in such a case, corticosteroid may be a potent therapeutic option.
我们报告了两名血清阴性干燥综合征老年患者,其计算机断层扫描显示胰腺出现良性肿胀。活检唇部组织的免疫染色或血清检查证实IgG4产生增加,从而诊断为自身免疫性硬化性胰腺炎(ASP),这是胰腺无症状肿胀的原因。一名患者的干燥症状和ASP自发改善,另一名患者对口服泼尼松龙反应良好。血清阴性干燥综合征和ASP可作为IgG4相关系统性疾病的临床表现同时出现,尤其是在老年患者中,在这种情况下,皮质类固醇可能是一种有效的治疗选择。