Higuchi M, Migita T, Yoshizawa S, Horiuchi T, Nakashima H, Niho Y
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka-city.
Ryumachi. 1998 Feb;38(1):34-8.
A 53-year-old woman who had xerostomia for ten years was admitted to our hospital because of refractory lower abdominal pain and pollakisuria of five years duration. Although she had undergone surgical treatments including cholecystectomy, ovarian cystectomy and groin hemiorrhaphy, she still suffered from abdominal symptoms. A diagnosis of interstitial cystitis was confirmed by hydraulic distention during a cystoscopic examination and by histopathological examination of the bladder. Her symptoms disappeared soon after the cystoscopic procedure, which also had a therapeutic effect of interstitial cystitis. Laboratory findings revealed hypergammaglobulinemia, a high titer of rheumatoid factor, positive anti-nuclear antibody, and positive anti-SS-A/Ro antibody. She was diagnosed as having primary Sjögren's syndrome based on the results of a gum test (8.5 ml/ 10 min), sialography (Stage II), and a positive minor salivary gland biopsy. Starting one month after the hydraulic distention, her abdominal symptoms gradually reappeared along with elevation of her serum IgG level. These features were markedly improved with 30 mg/day of oral prednisolone, which was then successfully tapered. These results suggested that interstitial cystitis in this case was caused by immunological abnormalities associated with Sjögren's syndrome.
一名患有口干症十年的53岁女性因持续五年的顽固性下腹痛和尿频而入住我院。尽管她接受了包括胆囊切除术、卵巢囊肿切除术和腹股沟疝修补术在内的外科治疗，但仍有腹部症状。膀胱镜检查时通过水扩张以及膀胱组织病理学检查确诊为间质性膀胱炎。膀胱镜检查后她的症状很快消失，该检查对间质性膀胱炎也有治疗作用。实验室检查结果显示高球蛋白血症、高滴度类风湿因子、抗核抗体阳性和抗SS - A/Ro抗体阳性。根据牙龈试验结果（8.5毫升/10分钟）、唾液造影（II期）以及小唾液腺活检阳性，她被诊断为原发性干燥综合征。在水扩张术后一个月开始，她的腹部症状随着血清IgG水平升高逐渐再次出现。口服泼尼松龙30毫克/天可使这些症状明显改善，随后成功减量。这些结果表明该病例中的间质性膀胱炎是由与干燥综合征相关的免疫异常引起的。
