Grevers G, Späth M, Krüger K, Schattenkirchner M
Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Ludwig-Maximilians-Universität München.
Laryngorhinootologie. 1990 Nov;69(11):605-7. doi: 10.1055/s-2007-998262.
In order to characterize typical findings in patients (pts.) with secondary Sjögren's Syndrome (SS) associated with rheumatoid arthritis (RA), 173 patients with RA were studied. Pathological screening-test results (Schirmer- and Saxon-test) were followed by ENT- and ophthalmological investigations and examinations in the field of internal medicine. Secondary SS associated with RA was diagnosed in 34 pts. (20%). Immuno-serological SS-A and/or SS-B-antibodies were found in 11 (32%) of 34 patients. 9 pts. (27%) had antinuclear antibodies. Abnormal titers of circulating immune complexes were present in the sera of 24 pts. (71%), salivary gland-antibodies in 3 pts. (9%). In 16 of 34 pts. (47%) minor salivary gland biopsy was performed. Lympho-plasma cell sialadenitis could be verified in all pts. Immuno-histological reactions to anti-IgG and/or anti-IgM and/or anti-IgA were detected in 10 (62%) of 16 pts. We could not find a single criterion to ascertain the diagnosis SS which still has to be made by considering all clinical and serological findings. Immunological findings may provide helpful and interesting diagnostic aspects which by long term observation may even gain importance; however, no differential therapeutic consequences can be seen at the moment.
为了明确类风湿关节炎(RA)相关的继发性干燥综合征(SS)患者的典型表现,对173例RA患者进行了研究。在进行病理筛查试验(Schirmer试验和Saxon试验)后,接着进行了耳鼻喉科和眼科检查以及内科领域的检查。34例(20%)患者被诊断为与RA相关的继发性SS。34例患者中有11例(32%)检测到免疫血清学的SS - A和/或SS - B抗体。9例(27%)患者有抗核抗体。24例(71%)患者血清中循环免疫复合物滴度异常,3例(9%)患者有唾液腺抗体。34例患者中有16例(47%)进行了小唾液腺活检。所有患者均证实有淋巴细胞 - 浆细胞性涎腺炎。16例患者中有10例(62%)检测到对抗IgG和/或抗IgM和/或抗IgA的免疫组织学反应。我们找不到单一的标准来确诊SS,目前仍需综合考虑所有临床和血清学表现来做出诊断。免疫学发现可能提供有用且有趣的诊断依据,通过长期观察甚至可能变得更加重要;然而,目前尚未发现有差异的治疗结果。