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ID PMID Title PublicationDate abstract
7747145 Evaluation of a Swedish version of the Arthritis Impact Measurement Scales (AIMS). 1995 A Swedish version of the self-administered health status questionnaire, Arthritis Impact Measurement Scales (AIMS), was evaluated in 147 patients with seropositive rheumatoid arthritis (RA). The internal consistency (Cronbach's alpha) of the subscales ranged from 0.57 to 0.90. The test-retest study with one month's interval showed a significant (p < 0.05) difference between the first and second measurements for Depression. The AIMS physical subscales correlated well with the components of a Swedish version of the Health Assessment Questionnaire and the psychological subscales of the AIMS had a high and significant correlation to the different dimensions of the Mood Adjective Check List. The Swedish version of the AIMS was considered to have satisfactory reliability and validity. It has proved its value as an outcome measure in previous drug trials, but was not sensitive to change in a short-term programme of active hand training.
8531357 [HTLV-I infection in primary Sjögren's syndrome--epidemiological, clinical and virologica 1995 Oct The HTLV-I seroprevalence rate among the patients with Sjögren's syndrome (SjS, 23.0%) was significantly higher than that among blood donors (3.4%). The age-adjusted summary odds ratio of HTLV-I infection among SjS patients as compared with blood donors was 3.1. The etiologic fraction, i.e., the proportion of SjS in the study population that are attributable to HTLV-I infection, was estimated to be 17.6%. Titers of serum antibodies to HTLV-I in the seropositive SjS patients were significantly higher than those among healthy carriers. IgM class antibodies were commonly detected in sera of SjS patients. Salivary IgA class antibodies were common among seropositive SjS patients, but not in HAM patients or in healthy subjects. The findings strongly suggest that HTLV-I is involved in the pathogenesis of the disease in a subset of patients with SjS in endemic areas.
8563118 Relapsing polychondritis associated with subclinical Sjögren's syndrome and phlegmon of t 1995 Aug A 25-year-old woman, diagnosed with Sjögren's syndrome at age 20, presented with painful edema of her left neck. Three days later, she additionally complained of bilateral auricular pain, and her nasal cartilage was tender to palpation. She was diagnosed as having phlegmon on the basis of her neck findings. Anti-human cartilage antibodies were demonstrated by indirect immunofluorescence, and the diagnosis of relapsing polychondritis was established. The patient was administered antibiotics and a non-steroidal anti-inflammatory drug, and her symptoms gradually improved. Relapsing polychondritis is one of the possible complications of autoimmune diseases, and infection might be a precipitating factor for this disease.
8025208 Complement activation in patients with primary Sjögren's syndrome: an indicator of system 1993 Sixteen patients with primary Sjögren's syndrome, verified according to the Copenhagen criteria, were investigated for evidence of complement activation. Thirteen of the patients had intact functional activity of both the classical and alternative pathways, with normal concentrations of the complement proteins C1q, C1s, C3, C4 and the complement protein fragments C2a and C3d in the circulation. In contrast, three patients showed clear evidence of complement activation. Further investigation of these patients revealed manifestations of glomerulonephritis, vasculitis and primary biliary cirrhosis. Six months later, one patient developed a malignant non-Hodgkin lymphoma. We conclude that complement activation is generally not associated with primary Sjögren's syndrome. Evidence of complement activation in patients considered to have primary Sjögren's syndrome should raise the suspicion of concomitant systemic disease and/or extraglandular activity.
9018459 Advances in palliative care for the patient with scleroderma. 1996 Nov Few studies published within the past year have addressed palliative care for the patient with scleroderma or systemic sclerosis. However, progress continues to be made, and important contributions have been made with respect to different vasodilator preparations for Raynaud's phenomenon, a possible role for diltiazem in the treatment of calcinosis, and the treatment of gut dysmotility. A number of comprehensive review papers on different aspects of management, mainly organ based, were included in the recently published textbook Systemic Sclerosis. Until there is an effective disease-modifying treatment for systemic sclerosis, management will be largely palliative and is best delivered by a multidisciplinary team.
8774163 Cardiac manifestations in primary Sjögren's syndrome. 1996 Jul OBJECTIVE: To determine cardiac manifestations in primary Sjögren's syndrome (SS). METHODS: Echocardiographic examination was undertaken in 64 patients (62 women, two men) with primary SS (54 definite (DSS) and 10 probable (PSS)) who had systemic symptoms. Twenty one healthy women volunteers of similar age acted as controls. RESULTS: Acute exudative pericarditis occurred in only one patient. An echogenic pericardium was demonstrated in 21 patients (19 DSS, two PSS) (33%) who had a previous symptom free pericarditis, but in none of the controls. Pulmonary pressure was significantly greater in the patients than in the controls (31 (SD 8) mm Hg compared with 24 (7) mm Hg), but there was no significant difference between the DSS and PSS groups. Left ventricular (LV) systolic function was similar in patients and controls. Twenty two patients (20 DSS, two PSS) and one control subject were excluded from LV diastolic function evaluation because of conditions likely to influence the parameters. Of the remaining 42 patients with SS (34 DSS, eight PSS), 21 (17 DSS, four PSS) had impaired diastolic function, confirmed by several diastolic parameters. LV diastolic dysfunction and echogenic pericardium occurred independently of each other, and there was no correlation between the occurrence of these silent cardiac abnormalities and the clinical and laboratory findings. CONCLUSIONS: Obvious cardiac involvement is rare in primary SS, but clinically silent manifestations (symptom free pericarditis and LV diastolic dysfunction) are common. The clinical and prognostic significance of these changes cannot yet be defined.
8792804 Primary Sjögren's syndrome complicated by hemolytic uremic syndrome. 1996 We describe a case of primary Sjögren's syndrome complicated by hemolytic uremic syndrome (HUS), possibly the first report of this association. The immunohistochemical findings suggest that immune complexes may have contributed to the endothelial injury and the pathogenesis of HUS in this case.
7861643 [An autopsy case of Sjögren syndrome with organized and fresh subdural hemorrhage (hemato 1994 Dec An autopsy case of Sjögren syndrome with organized and fresh subdural hemorrhages (hematoma) is reported. A 49-year-old woman who had been suffering from Sjögren syndrome had gradually lost her consciousness and was taken to the hospital where she died several hours later. Subsequently a doctor found the subdural hematoma of unknown origin on her Brain CT. At autopsy, her skin was dry and all of her teeth were missing. There were sporadic cutaneous purpura and subcutaneous hemorrhages in her trunk and limbs. The histopathological examination revealed that the submandibular gland had no normal acini, and was replaced by fibrous and adipose tissues with numerous lymphocytes. There were signs of fibrosis with inflammation in her liver, kidneys and lungs. The thyroid gland showed thyroiditis. Serological findings showed a significant high level of antinuclear antibody, positive RA factor and high gamma-globulinemia. The autopsy revealed that her cause of death was acute subdural hematoma and uncal herniation. There were no external injuries on her head or face. It is suggested that her acute subdural hematoma according to the hemorrhagic tendency, affected by her Sjögren syndrome.
8531340 [Classification criteria for Sjögren's syndrome--sensitivity and specificity of criteria 1995 Oct In patients with primary Sjögren's syndrome sensitivity of Japanese criteria was 82.0% and specificity was 82.7%: sensitivity of European criteria was 73.3%, and specificity was 88.9%. In patients with secondary Sjögren's syndrome sensitivity of Japanese criteria was 74.5% and specificity was 85.7%: sensitivity of European criteria was 70.2%, and specificity was 89.3%. False-negative patients with decreased sensitivity of both criteria mostly showed a positive labial salivary gland biopsy without ovart dry mouth and dry eye symptoms. False-positive patients with decreasing specificity of both criteria were those who had only keratoconcunctivitis sicca without a positive labial salivary gland biopsy.
8009013 [Cardiac complication of adult-onset Still's disease: from pericarditis to tamponade, some 1993 Cardiac tamponade is very seldom complication of adult onset-Still's disease. We reported 2 cases; it was the first manifestation of the disease in one case.
8929642 A rare case of cardiac sarcoidosis in a patient with progressive systemic sclerosis, Sjogr 1995 Dec A 56-year-old woman with overlap syndrome of progressive systemic sclerosis (PSS), Sjogren's syndrome, and polymyositis is reported. She developed complete atrioventricular (AV) block and progressive bilateral hilar adenopathy, and was diagnosed as having sarcoidosis by histological examination of the hilar lymph nodes biopsied thoracoscopically. Although coexistence of one or two autoimmune diseases with sarcoidosis is not uncommon, coexistence of three or more autoimmune diseases with sarcoidosis is rare. To our knowledge, the described case is the first case in which the three above-mentioned autoimmune diseases were accompanied by myocardial sarcoidosis.
8531367 [Chronic pancreatitis and pancreatic dysfunction associated with Sjögren's syndrome]. 1995 Oct Some pancreatic involvement was observed in Sjögren's syndrome (SS). Episodes of abdominal pain occurred infrequently in the course of SS, but there were some abnormal findings of the pancreatic functions and/or morphologic examinations. The level of serum amylase was affected by the destruction of both the pancreas and the salivary gland. Hyposecretion of bicarbonate in secretin test seemed to be characteristic in SS. ERP showed mild or moderate changes of the pancreatic duct, but their severities did not correlate with those of the salivary gland. Imaging of the pancreas tended to reveal definite abnormalities only in cases with an attack of pancreatitis. The roles of autoimmune mechanisms have been reported in pancreatitis associated with SS.
8531356 [Exocrinopathy resembling Sjögren's syndrome induced by a murine retrovirus]. 1995 Oct Recently, retrovirus is suggested to participate in the pathogenesis of Sjögren's syndrome (SjS). During the course of our study on mice infected with LP-BM5 murine leukemia virus, we found SjS-like systemic exocrinopathy in those mice. This virus is known to induce murine acquired immunodeficiency syndrome (MAIDS) in sensitive strains of mice. Most cells infiltrating into the glands were composed of CD3+ T cells (CD4-dominant), Mac-1+ cells and also B220+ cells. The virus genome was detected in the submandibular glands by immunohistochemistry or by PCR and the retroviral particles were also detected by electron microscopy. This mice might become an animal model for SjS and provide us with valuable informations for analysing the mechanism of how a retrovirus could induce SjS.
7991295 Primary Sjögren's syndrome and gamma heavy chain disease. 1994 Jul We describe a patient who has primary Sjögren's syndrome associated with asymptomatic gamma heavy chain disease and a tubulointerstitial nephritis. Sjögren's syndrome is known to be complicated by lymphoproliferative disorders and tubulointerstitial nephritis but gamma heavy chain disease is rare (approximately 100 cases described). There is one previously reported case of gamma heavy chain disease associated with primary Sjögren's syndrome and 2 cases associated with secondary Sjögren's syndrome. Our patient and the 3 other patients described in the literature did not have evidence of an underlying lymphoproliferative disorder.
8088072 Leucocytoclastic vasculitis as presenting feature of primary Sjögren's syndrome. 1994 Jun Described are two patients whose primary Sjögren's syndrome presented as leucocytoclastic vasculitis of the skin. One patient initially admitted complaints of dryness of the eyes and the mouth after direct questioning, and serologic testing revealed the presence of Ro/SS-A and La/SS-B antibodies. In the other patient the presence of antinuclear antibodies and rheumatoid factors in serum were the only suggestions of the presence of primary Sjögren's syndrome. Primary Sjögren's syndrome should be considered in patients presenting with leucocytoclastic vasculitis.
8178625 Neurological and neuropsychiatric dysfunction in primary Sjögren's syndrome. 1994 Jan In a prospective clinical investigation of 20 patients with primary Sjögren's syndrome (SS), neurological complications, not attributable to other diseases were detected in 14 patients (= 70%). Dysfunction of the peripheral nervous system (PNS) was nearly twice as frequent as central nervous system (CNS) complications. PNS involvement was dominated by symmetric sensory neuropathies, carpal tunnel syndromes, cranial nerve palsies (above all trigeminal sensory neuropathy) and pupillary dysfunction. CNS impairment was represented by cortical atrophy (n = 4), hemiparesis (n = 1) and aseptic meningitis (n = 1). Though CNS complications were rare, psychometric testing revealed diminished cognitive capacity in 14 patients. In addition to the characteristic sicca syndrome patients suffered from musculoskeletal pain and recurring abnormal sensation which frequently lead to the misdiagnosis of functional disorders. Additionally the frequent occurrence of psychiatric symptoms such as nervosity and depression support the impression of a psychosomatic pattern with no organic basis.
8174970 Phlegmonous gastritis: an unusual presenting symptom of Sjögren's syndrome. 1993 Aug This case report describes the histological and macroscopic changes seen within a few months in the gastric mucosa of a 28 year old woman patient with upper abdominal symptoms. With hindsight these changes were the first signs of Sjögren's syndrome.
1628170 Ophthalmological examinations of patients with primary Sjögren's syndrome selected from a 1992 Jul Ophthalmological examination of patients with primary Sjögren's syndrome (SS) (n = 44) taken randomly from a rheumatological practice revealed that in this population group the eyes were frequently but not seriously involved (n = 42). Primary SS patients (n = 44) could not be separated from patients suspected of primary SS, in whom the diagnosis had been excluded (n = 21) on the basis of ocular examination, but they were clearly distinguishable from healthy controls (n = 26). The diagnostic value of the tests currently in use to establish the diagnosis keratoconjunctivitis sicca in primary SS such as Schirmer's, tear film break up time and rose bengal staining tests appeared to be limited. These results demonstrate the heterogeneity of the syndrome, the influence of patient selection on patient characteristics in different primary SS populations and the limited value of using the present classification criteria for the diagnosis primary SS in individual patients.
7502256 [Salivary gland diseases]. 1995 Nov Only about 1% of head and neck tumors are neoplasms of the salivary glands. The majority [80%] of these tumors are benign. Pleomorphic adenomas, the most frequent benign tumors of the salivary glands, can transform into malignancy, especially after a long duration. Treatment of salivary gland tumors consists of complete surgical excision by a surgeon experienced in microsurgery of the facial nerve. Acute suppurative and viral sialadenitis is usually treated by the general practitioner either symptomatically or, if possible, specifically. Chronic sialadenitis, sialadenosis, Sjögren's syndrome, and Frey's syndrome often need long-term follow-up and medical treatment, which is also usually delivered by the general practitioner, after the diagnosis has been established. Trauma to the salivary gland with transsection of the duct or facial nerve needs immediate microsurgical repair by an otolaryngologist. Sialolithiasis is also treated surgically in most cases.
8746917 Atypical presentation of adult Still's disease mimicking acute bacterial endocarditis. 1995 Oct Adult Still's disease is a chronic, systemic disease of unknown origin. We describe the case of an otherwise healthy man with an uncommon presentation of Still's disease. A 38-year-old man presented with sore throat, fever, rash and arthritis. Laboratory findings showed that both erythrocyte sedimentation rate and ferritin had increased. Transoesophageal echocardiography revealed a vegetation involving the aortic leaflet. The diagnosis of Still's disease was made after the exclusion of infectious endocarditis, based upon the clinical picture, the high level of ferritin and the follow-up. The patient markedly improved after treatment with prednisone 1 mg. kg-1. This controlled and then progressively reduced the disease; the drug was then withdrawn. This case illustrates that Still's disease can present with endocardial involvement mimicking acute bacterial endocarditis as a first clinical manifestation. The observation suggests that the presence of high ferritinaemia in a patient with some clinical criteria of Still's disease could lead to an early diagnosis.