Shimoyama Kumiko, Ogawa Noriyoshi, Dei Yoshiaki, Suzuki Daisuke, Saito Miwako, Hayashi Hideharu
Third Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
Mod Rheumatol. 2007;17(6):514-7. doi: 10.1007/s10165-007-0621-8. Epub 2007 Dec 20.
A 65-year-old woman who had fever was admitted. Laboratory data showed renal tubular dysfunction, elevated C-reactive protein, soluble interleukin-2 receptor (sIL-2R), and IgG. Her blood showed proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) as well as antinuclear antibody and anti-Ro/SS-A antibody. Salivary gland and renal biopsy showed inflammatory infiltration of lymphocytes. A diagnosis of Sjögren's syndrome (SS) and interstitial nephritis was made. beta(2)-microglobulin, sIL-2R, IgG, and PR3-ANCA were decreased in response to medium-dose oral prednisolone. Antineutrophil cytoplasmic antibody could be a new marker for extraglandular features of SS. It would be beneficial for SS patients who have positive ANCA to investigate extraglandular lesions such as interstitial nephritis.
一名发热的65岁女性入院。实验室检查显示存在肾小管功能障碍、C反应蛋白、可溶性白细胞介素-2受体（sIL-2R）和IgG升高。其血液中显示出蛋白酶3-抗中性粒细胞胞浆抗体（PR3-ANCA）以及抗核抗体和抗Ro/SS-A抗体。唾液腺和肾脏活检显示淋巴细胞炎性浸润。诊断为干燥综合征（SS）和间质性肾炎。中剂量口服泼尼松龙治疗后，β2-微球蛋白、sIL-2R、IgG和PR3-ANCA下降。抗中性粒细胞胞浆抗体可能是SS腺外表现的新标志物。对于ANCA阳性的SS患者，检查如间质性肾炎等腺外病变可能有益。
