Division of Haematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Division of Oral and Maxillofacial Surgery, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
J Int Med Res. 2024 Nov;52(11):3000605241293986. doi: 10.1177/03000605241293986.
This current case report describes a Japanese woman in her 80s with xerostomia who presented with salivary gland dysfunction. She was positive for isolated anti-Ro52/SS-A antibody as determined by a chemiluminescent enzyme immunoassay and positive on a fluorescence enzyme immunoassay that recognizes both Ro52 and Ro60 antigens. A high serum concentration of anti-Ro52/SS-A antibody was determined by an enzyme-linked immunosorbent assay. A high anti-centromere antibodies (ACA) titre was also observed. Although Raynaud's phenomenon or a high serum immunoglobulin G concentration were not observed, Masson-trichrome staining of the patient's labial salivary glands showed considerable fibrosis. Her serum type I and type II interferon concentrations were normal. The present patient is the first with Sjögren's syndrome (SS) to exhibit isolated anti-Ro52/SS-A antibody and ACA without anti-Ro60/SS-A antibody. This current case report presents her case together with those of four other SS patients who were positive for isolated anti-Ro52/SS-A antibody. The SS literature also includes cases positive for ACA and describes clinical characteristics. The other four SS patients with isolated anti-Ro52/SS-A antibody described here had no ACA; interstitial pneumonia and polyneuropathy were observed in these cases, although there was no consistent tendency regarding types I and II interferon.
本病例报告描述了一例 80 多岁的口干日本女性,表现为唾液腺功能障碍。她的抗 Ro52/SS-A 抗体呈阳性,通过化学发光酶免疫分析法确定,荧光酶免疫分析法可识别 Ro52 和 Ro60 两种抗原。通过酶联免疫吸附试验确定了抗 Ro52/SS-A 抗体的血清高浓度。还观察到高抗着丝点抗体(ACA)滴度。尽管未观察到雷诺现象或高血清免疫球蛋白 G 浓度,但患者唇腺的 Masson 三色染色显示出相当程度的纤维化。她的血清 I 型和 II 型干扰素浓度正常。本患者是首例表现为孤立性抗 Ro52/SS-A 抗体和 ACA 而无抗 Ro60/SS-A 抗体的干燥综合征(SS)患者。本病例报告连同另外 4 例抗 Ro52/SS-A 抗体阳性的 SS 患者的病例一起呈现。SS 文献还包括 ACA 阳性的病例,并描述了临床特征。此处描述的另外 4 例具有孤立性抗 Ro52/SS-A 抗体的 SS 患者没有 ACA;这些病例观察到间质性肺炎和多发性神经病,尽管 I 型和 II 型干扰素没有一致的趋势。