Tilch D A, Schäfer H-G, Winter R
Augenklinik Tausendfensterhaus Dr. Klein GmbH, Duisburg.
Klin Monbl Augenheilkd. 2007 May;224(5):427-30. doi: 10.1055/s-2007-963097.
Sjögren's syndrome (SS) is a common connective tissue disease concerning 0.5 % of the white population. Typical symptoms are dry eyes and a dry mouth. The diagnostics of SS often are difficult, especially during early stages of the disease as long as the leading symptoms have not yet fully developed. Previously employed serum antibodies have neither been sensitive nor specific enough to be able to differentiate SS from different rheumatic diseases. We report on a patient with relapsing corneal erosions. In his case we have been able to support the diagnosis of SS by detecting the anti-alpha-fodrin-antibody as well as antinuclear antibodies.
The patient appeared with incomplete closure of the eyelids and corneal ulcers on both eyes. Smears of the conjunctivae from both eyes were sterile. Schirmer's test indicated a decrease in tear production with 5 mm in the right eye and a normal tear production with 19 mm in the left eye. Three months before, the results of this test had been even more pronounced with 1 mm and 3 - 4 mm, respectively. Additionally the patient described relapsing erosions and a dry mouth. We then examined his blood to help diagnose SS. Results were negative for rheumatoid factor, anti-Ro/SSA antibody and anti-La/SSB antibody, but positive for anti-nuclear-antibodies. In order to spare the patient an invasive biopsy we examined the anti-alpha-fodrin-antibody which was positive.
Even with negative anti-Ro/SSA and anti-La/SSB antibodies the positive anti-alpha-fodrin-antibody supported the diagnosis of SS. Therefore, we consider it a useful addition to the diagnostics previously employed in the diagnosis of SS (Schirmer's-test, anti-Ro/SSA-AK, anti-La/SSB-AK, rheumatoid factor, eventually biopsy).
干燥综合征（SS）是一种常见的结缔组织疾病，在白种人群中的发病率为0.5%。典型症状为眼干和口干。SS的诊断通常较为困难，尤其是在疾病早期，因为主要症状尚未完全显现。此前使用的血清抗体既不够敏感也不够特异，无法将SS与其他风湿性疾病区分开来。我们报告了一例复发性角膜糜烂患者。在该病例中，通过检测抗α- fodrin抗体和抗核抗体，我们得以支持SS的诊断。
该患者双眼睑闭合不全，角膜溃疡。双眼结膜涂片无菌。泪液分泌试验显示右眼泪液分泌减少至5毫米，左眼泪液分泌正常为19毫米。三个月前，该试验结果更为明显，右眼为1毫米，左眼为3 - 4毫米。此外，患者描述有复发性糜烂和口干。然后我们检查了他的血液以帮助诊断SS。类风湿因子、抗Ro/SSA抗体和抗La/SSB抗体结果均为阴性，但抗核抗体为阳性。为避免患者进行侵入性活检，我们检测了抗α- fodrin抗体，结果为阳性。
即使抗Ro/SSA和抗La/SSB抗体为阴性，抗α- fodrin抗体阳性仍支持SS的诊断。因此，我们认为它是此前用于SS诊断（泪液分泌试验、抗Ro/SSA-AK、抗La/SSB-AK、类风湿因子，最终活检）的诊断方法的有益补充。
