Chen Pei-Hsuan, Yang Yao-Hsu, Lin Yu-Tsan, Lee Jyh-Hong, Wang Li-Chieh, Yu Hsin-Hui, Chiang Bor-Luen
Rheumatol Int. 2014 Aug;34(8):1123-7. doi: 10.1007/s00296-013-2870-5.
This study aimed to characterize the manifestations of clinical symptoms and signs, primary rheumatic diseases, and other autoantibodies in pediatric patients with positive anti-SSA and/or anti-SSB antibodies. Subjects under age 18 with positive anti-SSA and/or anti-SSB antibodies were screened and enrolled in a tertiary hospital in Taiwan. Data were collected via medical records,including age, gender, onset of the primary rheumatic disease, clinical symptoms and signs, and the medication used. Schirmer test for Sjögren's syndrome (SS) screening was performed in all enrolled patients. Among twenty enrolled subjects, seventeen of them had systemic lupus erythematosus; four of them were diagnosed as SS with positive Schirmer test. In addition to antinuclear antibodies and anti-DNA antibodies, other common autoantibodies were anti-RNP antibodies (50 %) and anti-Sm antibodies(30 %). The most common symptoms were arthritis (60 %)followed by malar rash (40 %). In conclusion, we observed that a low proportion of childhood SS (4/20) exists in our patients with positive SSA and/or anti-SSB antibodies. It is suggested that clinicians should focus more on the clinical symptoms in these patients, rather than undertaking invasive diagnostic interventions to rule out Sjögren's syndrome.
本研究旨在描述抗SSA和/或抗SSB抗体阳性的儿科患者的临床症状和体征、原发性风湿性疾病及其他自身抗体的表现。在台湾一家三级医院对18岁以下抗SSA和/或抗SSB抗体阳性的受试者进行筛查并纳入研究。通过病历收集数据,包括年龄、性别、原发性风湿性疾病的发病情况、临床症状和体征以及所使用的药物。对所有纳入研究的患者进行了用于筛查干燥综合征(SS)的Schirmer试验。在20名纳入研究的受试者中,17例患有系统性红斑狼疮;4例经Schirmer试验阳性被诊断为SS。除抗核抗体和抗DNA抗体外,其他常见的自身抗体为抗RNP抗体(50%)和抗Sm抗体(30%)。最常见的症状是关节炎(60%),其次是颧部皮疹(40%)。总之,我们观察到在抗SSA和/或抗SSB抗体阳性的患者中,儿童SS的比例较低(4/20)。建议临床医生应更多关注这些患者的临床症状,而不是采取侵入性诊断干预措施来排除干燥综合征。