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[干燥综合征合并间质性肺病的可行诊断——一篇讨论文章]

[Practicable diagnostics of Sjögren's syndrome in interstitial lung disease-A discussion article].

作者信息

Aringer Martin, Koschel Dirk, Dörner Thomas, Sewerin Philipp, Prasse Antje, Witte Torsten

机构信息

Bereich Rheumatologie, Medizinische Klinik und Poliklinik III, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.

UniversitätsCentrum für Autoimmun- und Rheumatische Erkrankungen (UCARE), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Deutschland.

出版信息

Z Rheumatol. 2023 May;82(4):321-324. doi: 10.1007/s00393-023-01344-3. Epub 2023 Mar 22.

Abstract

Sjögren's syndrome (SjS) is a possible autoimmune cause of interstitial lung disease. The diagnostic pathway for SjS, however, is largely undefined in comparison to other systemic autoimmune diseases. Subjective sicca symptoms, anti-SS-A/Ro antibodies and even ANA as screening tests all have relevant limitations in sensitivity and/or specificity. Against this background, in an interdisciplinary discussion we have developed a consensus for the clarification of SjS, which is presented here for broader discussion. In addition to ANA and anti-SS-A/Ro antibodies, antibodies against alpha-fodrin should be included. Objective measures of dryness, such a Schirmer and Saxon tests are important, as is a salivary gland biopsy in the absence of typical autoantibodies.

摘要

干燥综合征(SjS)是间质性肺疾病可能的自身免疫病因。然而,与其他系统性自身免疫性疾病相比,SjS的诊断途径在很大程度上尚不明确。主观干燥症状、抗SS-A/Ro抗体甚至作为筛查试验的抗核抗体(ANA)在敏感性和/或特异性方面均存在相关局限性。在此背景下,我们通过跨学科讨论制定了关于明确SjS的共识,现呈于此以供更广泛的讨论。除ANA和抗SS-A/Ro抗体外,还应包括抗α- fodrin抗体。客观的干燥指标,如施默试验和萨克森试验很重要,在缺乏典型自身抗体时进行唾液腺活检也很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3bd/10163068/f0d3fa752c53/393_2023_1344_Fig1_HTML.jpg

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