■干燥综合征是一种全身性免疫疾病,表现在眼睛和嘴巴干涩。文献中很少提到没有眼部表现的原发性干燥综合征。
作者报告了一例48岁女性,主诉口腔干燥和吞咽困难6个月。身体检查显示嘴唇干燥伴有角状唇炎,红斑的舌头,颊粘膜干燥,有多个龋齿。两侧的Stenson和Wharton的管道中唾液流量很少。她的眼科检查正常。实验室检查显示白细胞减少症,贫血,血小板减少症,升高的C反应蛋白水平和红细胞沉降率,强阳性的抗核抗体,反SS-A,反SS-,和风湿因子。超声检查显示两个腮腺的高回声结节。唾液腺活检示淋巴细胞浸润。诊断为原发性干燥综合征。她用毛果芸香碱5mg治疗3个月,维生素C,和用于口腔干燥的人工唾液。她正在接受持续的随访,缓解了50-60%,没有任何系统性并发症。
■Sjögren综合征影响外分泌腺,导致口干和眼睛,会引起全身症状,包括疲劳和关节痛。报告病例中眼部受累的发生率为86.1%,而我们的病人没有任何眼部受累,这是一种罕见的情况。鉴别诊断包括糖尿病,甲状腺功能减退,慢性病毒学感染,和一些引起干燥的药物,这是非常排除的。干燥症状的治疗涉及人工泪液和刺激唾液流动的药物,而全身性疾病的治疗包括皮质类固醇,和各种DMARD,利妥昔单抗。这种疾病增加了B细胞非霍奇金淋巴瘤发展的相对风险。因此,需要对病人进行监测,尤其是在存在危险因素的情况下。
■早期诊断这种疾病非常重要,使用各种诊断标准。
UNASSIGNED: Sjögren\'s Syndrome is a systemic immune disorder, manifested in dry eyes and mouth. Primary Sjögren\'s syndrome without ocular manifestation is seldom mentioned in the literature.
UNASSIGNED: The authors report a
case of a 48-year-old female who complained of dryness of mouth and dysphagia for 6 months. Physical examinations showed dry lips with angular cheilitis, an erythematous tongue, and dry buccal mucosa, with multiple carious teeth. The salivary flow was scanty from the Stenson\'s and Wharton\'s ducts on both sides. Her ophthalmological examination was normal. Laboratory tests revealed leukopenia, anemia, thrombocytopenia, elevated levels of C-reactive protein and erythrocyte sedimentation rate, a strongly positive antinuclear antibody, anti-SS-A, anti-SS-, and rheumatic factor. Hyperechoic nodules in both parotids were shown by Ultrasonography. Salivary gland biopsy showed lymphocytic infiltration. Diagnosis of primary Sjögren\'s syndrome was made. She was treated with Pilocarpine 5 mg for 3 months, Vitamin C, and artificial saliva for oral dryness. She is under continuous follow-up with 50-60% relief, without any systemic complications.
UNASSIGNED: Sjögren\'s Syndrome affects the exocrine glands causing dry mouth and eyes, and can cause systemic symptoms, including fatigue and joint pain. The incidence of ocular involvement among the reported cases is 86.1%, whereas our patient did not have any ocular involvement, and this represents a rare condition. The differential diagnosis included diabetes mellitus, hypothyroidism, chronic virology infection, and some medications that cause dryness, which were very much ruled out. Treatment of sicca symptoms involves artificial tears and medications that stimulate saliva flow while treatment of systemic disease includes corticosteroids, and various DMARDs, Rituximab. this disease has an increased relative risk for the development of B-cell non-Hodgkin\'s lymphoma. Therefore, patients need to be monitored, especially in the presence of risk factors.
UNASSIGNED: It is very important to diagnose this disorder early, using the various diagnostic criteria.