Ozasa Kana, Noma Noboru, Nakata Jumi, Imamura Yoshiki
Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Tokyo 101-8310, Japan.
Clinical Research Division, Dental Research Institute, Nihon University, Tokyo 101-8310, Japan.
Neurol Int. 2021 Sep 8;13(3):464-468. doi: 10.3390/neurolint13030045.
Liver and renal involvement is a rare event in Sjögren's syndrome. Sjögren's syndrome is characterized by the progressive immune-mediated destruction of epithelial tissues of the salivary and lacrimal glands. Sensory ganglionitis, accompanied by T-cell invasion, occurs in patients with Sjögren's syndrome, resulting in sensory neuropathy of the face or limbs. Patients are assessed by quantitative sensory testing. A 76-year-old woman presented with numbness of her left face and was subsequently diagnosed with Sjögren's syndrome and primary biliary cirrhosis, and was found to have renal failure. Detection of her serum anti-Ro/SSA antibody was strongly positive. Shirmer's test or a salivary volume in the gum test also showed positive results. Her somatosensory disturbance severity was higher in the trigeminal area than in the forearm, suggesting that the trigeminal nerve is more susceptible than other parts of the nervous system in patients with Sjögren's syndrome and primary biliary cirrhosis. A simple sensory test could be performed during regular check-ups, as sensory deficits might develop after patients are diagnosed with Sjögren's syndrome and primary biliary cirrhosis.
肝脏和肾脏受累在干燥综合征中是罕见事件。干燥综合征的特征是唾液腺和泪腺的上皮组织进行性免疫介导破坏。感觉性神经炎伴有T细胞浸润,发生于干燥综合征患者,导致面部或肢体感觉神经病变。通过定量感觉测试对患者进行评估。一名76岁女性因左侧面部麻木就诊,随后被诊断为干燥综合征和原发性胆汁性肝硬化,并发现患有肾衰竭。检测其血清抗Ro/SSA抗体呈强阳性。施默试验或牙龈唾液量试验也呈阳性结果。她的躯体感觉障碍严重程度在三叉神经区域高于前臂,提示在干燥综合征和原发性胆汁性肝硬化患者中,三叉神经比神经系统其他部位更易受累。在定期体检时可进行简单的感觉测试,因为患者被诊断为干燥综合征和原发性胆汁性肝硬化后可能会出现感觉缺陷。