Takasugi M, Hayakawa A, Hirakata H, Hiyama T, Tominaga K, Ibayashi H
Endoscopy. 1979 Nov;11(4):263-6. doi: 10.1055/s-0028-1098363.
The case of a 42-year-old woman with Sjögren's syndrome accompanied by severe gastric infiltration and interstitial nephritis is reported. Presentation was with finger stiffness, Raynaud's phenomenon and abdominal discomfort. There were endoscopic and radiological features of early cancer, type IIc (depressed type). Resected stomach showed atrophic gastritis with erosion. Histology showed focal to relatively diffuse destruction of the gastric glands with minimal intestinal metaplasia and dense collections of lymphoid cells with occasional germinal centers in the interstitium of the gastric mucosa. Renal biopsy revealed similar severe diffuse interstitial infiltration of lymphoid cells. Distal renal tubular acidosis was confirmed by sodium bicarbonate and ammonium chloride loading test. Satisfactory improvement in xerostomia, keratoconjunctivitis sicca and other laboratory data occurred on prolonged administration of adrenal steroids and cyclophosphamide.
报告了一例42岁患有干燥综合征并伴有严重胃浸润和间质性肾炎的女性病例。临床表现为手指僵硬、雷诺现象和腹部不适。内镜及放射学检查显示为IIc型（凹陷型）早期癌症特征。切除的胃显示为萎缩性胃炎伴糜烂。组织学检查显示胃腺灶性至相对弥漫性破坏，肠化生轻微，胃黏膜间质中有密集的淋巴细胞聚集，偶见生发中心。肾活检显示类似的严重弥漫性淋巴细胞间质浸润。碳酸氢钠和氯化铵负荷试验证实存在远端肾小管性酸中毒。长期使用肾上腺皮质激素和环磷酰胺后，口干、干燥性角结膜炎及其他实验室指标有了令人满意的改善。
