Chikazawa H, Nishiya K, Hashimoto K
Second Department of Internal Medicine, Kochi Medical School.
Nihon Rinsho Meneki Gakkai Kaishi. 1998 Feb;21(1):57-63. doi: 10.2177/jsci.21.57.
A 46 year-old female presented with dry eyes and a dry mouth which she had been experiencing for about 15 years. She also began to notice dizziness (orthostatic hypotension) during the last 5 years. The symptoms gradually increased whereupon she began to have polyarthralgia, facial flashing, hyper and hyposweating in some areas on the face and trunk. Her sialography showed a damaged parotid gland. Minor salivary gland biopsy revealed chronic sialoadenitis. The Sirmer test was low, and the Rosebengal test indicated keratoconjunctivitis sicca. Her serological tests showed hypocomplementemia and were positive for antinuclear antibody and SS-A antibody. The diagnosis of primary Sjögren's syndrome (SjS) was made based on these findings. Prednisolone, at a dose of 15 mg per day, was given orally. As a result of this therapy, arthralgia disappeared immediately, although it had no effect on the neuropathy found in this patient. This is a rare case of SjS associated with peripheral neuropathy and severe dysautonomia.
一名46岁女性出现干眼和口干症状，这种情况已持续约15年。在过去5年里，她还开始出现头晕（直立性低血压）。症状逐渐加重，随后她开始出现多关节痛、面部潮红、面部和躯干某些部位多汗和少汗。她的涎腺造影显示腮腺受损。小唾液腺活检显示慢性涎腺炎。施默试验结果偏低，玫瑰红试验表明存在干燥性角结膜炎。她的血清学检查显示补体减少，抗核抗体和SS - A抗体呈阳性。基于这些发现，诊断为原发性干燥综合征（SjS）。口服泼尼松龙，剂量为每日15毫克。经过这种治疗，关节痛立即消失，尽管对该患者的神经病变没有效果。这是一例罕见的与周围神经病变和严重自主神经功能障碍相关的干燥综合征病例。
