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ID PMID Title PublicationDate abstract
7744202 Condition judgement of dry eye in sicca syndrome. 1994 Sep In this paper, we presented 32 dry eyes of 16 random patients with primary Sicca Syndrome graded with rose bengal (rb), Break up time of tear film (BUT) and Schirmer 1 test (S1T). Of them, the lip biopsy and tear beta 2-M level were examined and overall studied. The results showed that the grade of dry eye was closely related with both the degree of lymphocyte infiltration of lip glands and level of tear beta 2-M, and indicated that our grading method for dry eye based on rb, BUT and S1T is depandable, and the lymphocyte infiltration of both lip and lacrymal gland may be the same qualitatively and quantitatively. so, how many lymphocytes appeared in the lip gland, how much concentration would be the tear beta 2-M Therefore judging the condition of dry eye by these 5 tests is dependable and simple too, as they need no complicated equipment.
7801137 A clinical and laboratory profile of symptomatic women with silicone breast implants. 1994 Aug One hundred seventy-six patients with breast prosthetic implants were evaluated. All women were symptomatic and were referred by either attorneys (152) or physicians (24) for rheumatic evaluation. The women ranged in age from 24 to 72 with a mean of 45 years. Indications for surgery were cosmetic (128), cancer (34), and other (14). Implants had been in place for 7 years or more in 120 patients and < 2 years in only 8. Eighty-three women required explantation of their original prostheses, and 63 had new implants inserted of which 47 were silicone and 16 were saline. Capsular contractures were present in 128 women, and documented implant rupture occurred in 67. Sixty-four women underwent manual closed capsulotomies. Of the 63 revisions, 37 resulted in contractures of the new implant. The most frequent symptoms seen in the women were chronic fatigue (77%) cognitive dysfunction (65%), arthralgia (56%), dry mouth (53%), dry eye (50%), alopecia (40%), and dysphagia (35%). The most common findings on physical examination were telangiectasias (60%), erythema of the chest wall (56%), carpal tunnel syndrome (47%), petechiae (46%), lacrimal gland enlargement (26%), thyroid tenderness (22%), thyroid enlargement (21%), and parotid enlargement (18%). Laboratory findings included elevated cholesterol (59%), elevated erythrocyte sedimentation rate (32%), elevated serum immunoglobulin (28%), and positive autonuclear antibody (25%) seen most often. Despite clinical features suggesting Sjögren's syndrome, antibodies to Ro (SSA) were seen in only 2 patients, and antibodies to La (SSB) were seen in only 4 patients. Siliconosis is a novel systemic disease with symptoms of chronic fatigue, cognitive dysfunction, sicca syndrome, and arthralgia.(ABSTRACT TRUNCATED AT 250 WORDS)
8167629 [Chronic hepatitis C and Gougerot-Sjogren syndrome. Apropos of a case]. 1993 Apr The authors report a patient with concomitant Sjögren's syndrome and chronic hepatitis C. Close associations between autoimmune liver disease, chronic hepatitis C, and Sjögren's syndrome have been demonstrated. The most likely hypothesis involves triggering of an autoimmune cascade by the hepatitis C virus. Prevalence of hepatitis C virus infection in patients with Sjögren's syndrome and potential therapeutic implications of this disease combinations remain to be determined.
8256034 [Thymoma and primary Gougerot-Sjögren syndrome progressing to severe bronchiolitis]. 1993 The authors report a case of a thymoma associated with Gougerot-Sjögren's syndrome in a patient aged 40 years. The excision of the thymic tumour and complementary radiotherapy lead to a remission in the patient. There was an unfavourable progression of this syndrome from a respiratory stand-point with the development of a predominantly bronchiolitic picture over four years.
1412534 [Lipid peroxidation and the status of the basal membrane of the acinar cells in the minor 1992 Mar Lipid peroxidation parameters were assessed from the levels of malonic dialdehyde, antioxidant activity from the blood and salivary total antioxidant activity, biopsy specimens of the minor salivary glands were examined by electron microscopy in 34 patients with Sjogren's disease. Both blood and salivary levels of malonic dialdehyde were found increased whereas total antioxidant activity lowered in these patients; destructive changes were detected in the acinar cells basal membranes. The authors suggest that spontaneous (because of insufficiency of antioxidant enzymic systems) lipid peroxidation reactions are responsible for these changes.
8757967 High prevalence of B-cell monoclonality in labial gland biopsies of Japanese Sjögren's sy 1996 Jul Patients with Sjögren's syndrome (SS) have an increased risk of developing malignant lymphoma. Although some clinical parameters may herald the imminent onset of lymphoma, few reliable markers are available to predict the progression to a malignant lymphoproliferative disorder. Although there are a number of immunological and serologic features that distinguish SS in Japanese patients, in common with their Western counterparts these patients also have an increased risk of lymphoid neoplasia. Recently we have reported finding a high prevalence (17%) of monoclonal immunoglobulin (Ig) heavy chain gene rearrangements in labial salivary gland (LSG) biopsies of Western SS using the polymerase chain reaction (PCR). In many cases this finding was predictive for the subsequent development of lymphoma. In this study LSG from 50 Japanese SS patients were examined for Ig heavy chain gene monoclonality using PCR to amplify the VDJ region and identified in 7 of 50 (14%) cases. Three patients with monoclonality in the LSG had evidence of lymphoma at extra-salivary gland sites. In one of these the diagnosis of lymphoma was made subsequent to lip biopsy. In the other two lymphoma at extra-salivary gland sites was diagnosed prior to LSG biopsy. The results suggest that the prevalence of Ig heavy chain gene monoclonality in LSG of Japanese SS patients is similar to that in the West, and that neoplastic cells can be identified in LSG as a component of more widely disseminated disease.
7545756 Vasculitis complicating granulocyte colony stimulating factor treatment of leukopenia and 1995 Jun Recombinant myeloid growth factors have been increasingly used in recent years to combat induced and disease associated neutropenia. Their application in the management of Felty's syndrome with intercurrent infection has raised concern that resultant neutrophilia and activation of a diverse array of polymorphonuclear cell functions may have an adverse effect on the rheumatoid disease process. We describe a patient with Felty's syndrome receiving short term treatment with recombinant human granulocyte colony stimulating factor (GCSF), who then developed acute renal failure in conjunction with leukocytoclastic vasculitis and presumptive gout. We address the issue of "adding fuel to the fire" and review reported implications of GCSF in induction of vasculitis.
7842538 IgA in Sjögren's syndrome. 1994 Sep Patients with Sjögren's syndrome (SS) display two sets of immunological abnormalities. B cells are oligoclonally activated, resulting in hypergammaglobulinaemia, elevated levels of circulating immune complexes (CIC) and non-organ specific autoantibodies. The cellular arm of the immune response is also involved, as shown by the predominance of activated T cells within the exocrine gland infiltrate. IgA could well bridge the gap between activated B cells and defective T cells and by doing so, play a pivotal role in the pathogenesis of SS. This interpretation is supported by the high proportion of IgA in immunoglobulin(Igl) production at the mucosal level. Additionally, IgA is the Igl class most dependent on T cell help. A number of studies over the past 15 years have reported high levels of serum and secretory IgA, IgA-rheumatoid factor and IgA-containing CIC. A correlation between disease activity and the latter abnormalities has recently been shown. There is, however, a need for longitudinal assessment of total IgA and IgA autoantibodies in order to further evaluate their role in the pathogenesis of the disease.
8106813 Recurrent swelling of parotid glands and Sjögren's syndrome. 1993 Dec This study included 125 patients with chronic parotitis, and it presents in particular, a long-term clinical, laboratory, and sialographic study of 22 patients who were diagnosed as having adult recurrent sialadenitis of the parotid glands (ARSPG). Twelve of the 22 patients with ARSPG were shown to have Sjögren's syndrome (SS). These patients had recurrent parotid gland swelling for 1.5-14 years (mean, 5.2 years) before xerostomia and keratoconjunctivitis sicca occurred. Ten of the 22 patients with ARSPG did not develop SS, but did experience recurrent parotitis which extended from childhood into adulthood. The ARSPG underwent remission in seven of these patients. It is suggested that patients with ARSPG, but without a history of parotid gland swellings in childhood, should be diagnosed provisionally as having subclinical SS (SCSS).
1339182 [Sequential quantitative scintigraphy of parotid glands with chronic inflammatory diseases 1992 Nov Sequential quantitative scintigraphy of parotid glands was performed in 16 cases with recurrent parotitis in childhood, 33 with chronic obstructive parotitis, 37 with Sjögren's syndrome, 4 with sialadenosis and 30 normal controls. Uptake function was normal, but excretion was retarded in recurrent parotitis in childhood. Chronic obstructive parotitis exhibited that excretion was obstructed and the uptake and excretion function between bilateral parotids was marked different. In Sjögren's syndrome, uptake was very low and excretion was heavily delayed. Sialadenosis showed that excretion was retarded and uptake function was not definitely involved. The possible mechanism of the scintigraphical features were analyzed combined with the histopathological findings.
1617898 Renal tubular acidosis in primary Sjögren's syndrome. 1992 Jun Renal tubular acidosis (RTA) is a frequent extraglandular manifestation of Sjögren's syndrome; however, no distinction on the incidence of this renal tubular defect between primary and secondary Sjögren's syndrome has been reported. This study was undertaken in order to define the frequency of RTA and the possible pathogenetic mechanisms in a group of 21 randomly selected primary Sjögren's syndrome patients. RTA was found in 7 (33%) patients. The incomplete type of the disorder was the most frequent. It seems that the etiology of RTA is multifactorial. Renal excretion of monoclonal proteins and the immunologically-induced interstitial inflammation are the main possible factors of this renal tubular defect.
1644955 The coexistence of psoriasis vulgaris, Sjögren's syndrome, and Hashimoto's thyroiditis. 1992 May A 52-year-old woman presented with psoriasis vulgaris, Sjögren's syndrome, and Hashimoto's thyroiditis with a 5-year history. She had a number of immunological abnormalities and typical psoriatic plaques over her entire body. The relationship between psoriasis, Sjögren's syndrome, and Hashimoto's thyroiditis is discussed from the viewpoint of immunology, and similar cases in the literature are reviewed. This is the first report of a coexistence of psoriasis vulgaris, Sjögren's syndrome, and Hashimoto's thyroiditis.
7956720 Prevention of spontaneous polyarthritis in NZB/KN mice by treatment with a novel thiazole 1994 NZB/KN mice spontaneously develop polyarthritis, characterized by infiltration of inflammatory cells into the synovium and destructive damage of articular cartilage and bone. This study was performed to elucidate the effects of a novel thiazole derivative (SM-8849; (4-[1-(2-fluoro-4-biphenylyl)-ethyl]-2-methylamino thiazole) in comparison with the cyclooxygenase inhibitor, indomethacin, on disease development and immune disorders in NZB/KN mice. Mice were treated with SM-8894 (50 mg/kg) or indomethacin (2 mg/kg), starting from two months of age, for seven months. Indomethacin had no inhibitory effect on joint lesions in this model. In contrast, SM-8849 was effective in arresting the progression of arthritis, as confirmed by histologic and radiographic studies. Moreover, SM-8849, but not indomethacin, suppressed rheumatoid factor production. In addition, the population of CD5+ B cells in the peritoneal cavity and spleen was reduced with SM-8849 treatment. These findings suggest that NZB/KN mice are of use in the evaluation of intrinsic antiarthritic activity, independently of cyclooxygenase inhibition. Additionally, the therapeutic value of SM-8849 is strongly suggested by its efficacy in this model.
8149841 Esophageal motility disorders in patients with Sjögren's syndrome. 1994 Apr Esophageal motility was studied in 21 patients with Sjögren's syndrome, and in 25 normal volunteers, in order to record the prevalence and type of esophageal motor abnormalities. Esophageal motor abnormalities were detected in seven of the 21 patients (33.3%). These esophageal abnormalities did not correlate with the presence of dysphagia, the extraglandular involvement, or the presence of autoantibodies.
8025591 Recurrent annular erythema with anti-SSA/Ro and anti-SSB/La antibodies localized on palms 1994 Feb A 69-year-old Japanese man with recurrent annular erythema localized on palms and flexor surface of fingers with anti-SSA/Ro and anti-SSB/La antibodies, is reported. The present case indicates that even in an elderly man with atypical localization, annular erythema with autoimmunity may be considered and serological analysis should be performed. Systematic studies will be required to understand the relationship between 'recurrent annular erythema associated with anti-SSB/La antibodies' in Japanese, subacute cutaneous lupus erythematosus (SCLE) and 'annular erythema associated with Sjogren's syndrome'.
7801057 Salivary gland scintigraphy in subjects with and without symptoms of dry mouth and/or eyes 1994 The major salivary glands were examined with 99m-Tc-pertechnetate scintigraphy in randomly selected subjects with (n = 30) and without (n = 12) symptoms of dry mouth and/or eyes, and in patients with primary Sjögren's syndrome (1 degree SS, n = 17). The scans were quantitatively evaluated and compared to other objective tests used to diagnose 1 degree SS. As compared with those for asymptomatic subjects, most values for the scintigraphic variables were non-significantly lower for symptomatic subjects and the time-activity curves were slightly flatter for all major salivary glands. In patients with 1 degree SS most values for the scintigraphic variables were significantly lowered and the submandibular glands were the glands most affected, as reflected in a flat time-activity curve, while the parotid glands were mainly affected during stimulated secretion. The scintigraphic variables correlated with the self-rated dryness of mouth in symptomatic subjects and with the abnormality of sialometry results in patients with 1 degree SS. We conclude that salivary gland scintigraphy is a sensitive and valid method to measure salivary gland function and abnormalities.
7685257 Tear fluid analysis in primary Sjögren's syndrome. 1993 Mar Tear fluid analysis was performed in 44 patients with primary SS, 21 patients suspected of having primary SS in whom the syndrome had been excluded, and 24 control subjects. In the primary SS patients the tear fluid levels of lactoferrin and a1-antitrypsin were increased and the tear fluid levels peroxidase, lysozyme and amylase were decreased. However, a considerable overlap in the concentrations of all of the tested substances in the different groups was found and the measurement of these substances cannot be advocated for diagnostic use.
8266032 Lambert-Eaton myasthenic syndrome associated with Sjögren's syndrome and discoid lupus er 1993 A 65-year-old woman with facial erythema and hypergammaglobulinemia developed excessive fatigability. A diagnosis of Lambert-Eaton myasthenic syndrome (LEMS) was made from electrophysiological studies. She had symptoms and laboratory data compatible with probable Sjögren's syndrome. Skin biopsy revealed the histological findings of discoid lupus erythematosus. Treatment with 3,4-diaminopyridine resulted in the improvement of fatigability. LEMS should be recognized as a treatable complication of systemic autoimmune diseases.
7974556 Sjögren's syndrome presenting as ischemic stroke. 1994 Nov BACKGROUND: We describe a young woman who presented with minor stroke as a first clinical symptom of Sjögren's syndrome (SS) in the absence of well-known risk factors for cerebrovascular disease. CASE DESCRIPTION: The medical history included recurrent miscarriages and sun rashes, which directed the diagnosis toward immunologic disorders such as systemic lupus erythematosus and antiphospholipid antibody syndrome, which are often associated with stroke. Only complete laboratory testing, including SSB antibody studies, and ophthalmologic and salivary gland evaluation revealed the correct diagnosis. CONCLUSIONS: Sjögren's syndrome should be considered among the causes of stroke, especially in a young female patient.
8519078 Primary Sjögren's syndrome. 1993 Feb Significant abnormalities in pulmonary function are encountered in about 24% of patients with primary Sjögren's syndrome. The most common cause of dyspnoea is interstitial fibrosis, with a prevalence of around 8%, but a number of other pathologies may be encountered in the lungs of these patients (Table 1). Lymphoproliferative disorders are relatively uncommon, but these apparently benign lesions may harbour malignant potential. Interstitial fibrosis and the lymphoproliferative disorders may be responsive to corticosteroids or cytotoxic agents, and it is therefore important to establish an accurate diagnosis at an early stage. On the basis of our experience we would recommend the investigative strategy outlined below. Patients should be screened for significant lung disease by taking a careful history of respiratory symptoms followed by standard pulmonary function testing (including measurement of carbon monoxide diffusing capacity) and chest radiography. High resolution computed tomography is a non-invasive technique that should prove superior to chest radiography in the detection of early cases of interstitial fibrosis. When the disease is patchy it may be useful in identifying areas of maximal involvement for subsequent biopsy. Bronchoalveolar lavage is a sensitive tool in the non-smoker, but lacks the specificity to command a significant role in the investigation of pulmonary pathology in these patients. One exception to this may be in the investigation of the clonality of lymphocytes which may allow early and specific diagnosis of lymphomatous proliferation. The application of techniques such as the polymerase chain reaction may assist in the investigation of the role of the Epstein-Barr virus in the causation of lymphoproliferative lesions. In most patients with significant symptoms and abnormalities of pulmonary function a tissue diagnosis will be required, either by transbronchial biopsy or by open lung biopsy. Both bronchial and interstitial lung tissue should be obtained where possible. Histological confirmation is probably mandatory when there is a recent history of parotid enlargement, weight loss or the appearance of a monoclonal gammopathy. Advances in our understanding of the mechanisms of the MALT system may provide the key to unlocking some of the mysteries of 'autoimmune' diseases such as Sjögren's syndrome. The response of lymphoproliferative disorders to immunosuppressive therapy provides hope that if the diagnosis of sicca syndrome can be made earlier lymphocyte induced tissue damage may be halted or reversed.