tate(p) globular(g) cavitary(c) destruc
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1 Key words: Clinical and laboratory findings SjƒÓgren's Corticosteroid syndrome therapy Mixed Connective Tissue Disease(MCTD)
2 tate(p) globular(g) cavitary(c) destruc
3 Table. 1 Classification of 160 patients with SjƒÓgren's syndrome Fig. 1 Age at diagnosis of SjƒÓgren's syndrome Fig. 2 Age at onset of SjƒÓgren's syndrome Table 2 Personal history of patients with SjƒÓgren's syndrome
4 Table 3 Frequency of eye, oral, nasal and genital symptoms in patients with SjƒÓgren's syndrome
5 Table 4 Clinical findings of patients with SjƒÓgren's syndrome Table 5 Clinical and laboratory findings in patients with SjƒÓgren's syndrome * KCS: Keratoconjunctivitis sicca
6 Table 6 Laboratory findings in patients with SjƒÓgren's syndrome Table 7 Symptomatic improvement and prednisolone dosis
7 Fig. 3 Effect of prednisolone therapv on Schirmer's test and gum test Table 8 Effect of prednisolone therapy on histological findings of salivary gland * Histological ** First biopsy findings of salivary gland *** Second biopsy
8 Fig. 4 Effect of prednisolone therapy on salivary gland findings Fig. 6 Effect of prednisolone therapy on serum ć-globulin levels Fig. 7 Effect of prednisolone therapy on serum amylase levels Fig. 5 Effect of prednisolone therapy on titer of anti SS-A antibody
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12 1. SjƒÓgren, H.: Zur Kennitis der Keratoconjunctivitis Sicca. Ada. Ophthalmol. (supp. 2), 1-151, Anderson, J. R., Gray, K. G., and Beck, J. S.: Precipitating autoantibodies in SjƒÓgren's disease. Lan cet 26, , Macsween, R. N. M., Goudie, R. B., Anderson, J. R., Armstrong, E., Murray, M. A., Mason, D. K., Jasani, M. K., BOyle, J. A., Buchanan, W. W., and Williamson, J.: Occurrence of antibody to salivary duct epithelium in SjƒÓgren's disease, rheumatoid arthritis, and other arthritides. A clinical and labora tory study. Ann. Rheum. Dis. 26, , Whaley, K., Chisholm, DM., Goudie, R. B., Downie, W. W., Dick, W. C., Boyle, J. A. and Williamson, J.: Salivary duct autoantibody in SjƒÓgren's syndrome. Correlation with focal sialadenitis in the labial mucosa. Clin. Exp. Immunol. 4, Chisholm, D. M. and Mason, D. K.: Labial salivary gland biopsy in SjƒÓgren's disease. J. Clin. Pathol. 21, , Tarpley, T. M., Anderson, L. G., and White, C. L.: Minor salivary gland involvement in SjƒÓgren's syn drome. Oral. Surg. 37, 64-74, Greenspan, J. S., Daniels, T. E., Talal, N. and Sylvester, R. A.: The histopathology of SjƒÓgren, s syn drome in labial salivary gland biopsies. Oral. Surg. 37, , Bloch, K. L., Buchanan, W. W., Wohl, M. J., and Bunim, j. j.: SjƒÓgren's syndrome. A clinical, patholo gical, and serological study of sixty-two cases. Medicine 44, , Shearn, M. A.: SjƒÓgren's syndrome. WB Saunders Company, Philadelphia, Schirmer, O.: Studien zur Physiologie und Pathologie der Tranenabsonderung and Tranenabfuhr. Arch. Ophthalmol. 56, , Rubin, P., and Holt, J. K.: Secretory sialography in disease of the major salivary glands. Am. J. Roentgenol. 77, , Kabat, E. A., and Mayer, M. M.: Experimental Immunochemistry 2nd Ed., Tomas, C. Co., Springfield, pp , 1961.
13 15. Alspaugh, M. A. and Tan, E. M.: Antibodies to cellular antigens in SjƒÓgren, s syndrome. J. Clin. Invest. 55, , Hadden, W. B.: On "dry mouth", or suppretion of the salivary and buccal secretions. Trans. Clin. Soc. (London) 21, , Whaley, K., Williamson, J., Chisholm, D. M., Webb, J., Mason, D. K. and Buchanan, W. W.: SjƒÓgren, s syndrome. Sicca components Q. J. Med. 12, , Bunim, J. J., Buchanan, W. W., Werrlake, P. T., Sokoloff, L., Bloch, K. J., Beck, J. S. and Alepa, F. P.: Clinical, pathologic studies in SjƒÓgren, s syndrome. Combined Clinical Staff Conference at the Na tional Institutes of Health. Ann. Intern. Med. 61, , Oribe, K., and Nobunaga, N.: Pancreas in SjƒÓgren's syndrome. Rheumatology. 7, 3-8, Williamson, J., Doig, W. M., Forrester, J. V., Tham, M. H., Wilson, T., Whaley, K. and Dick, W. C.: Ma Management of the dry eye in SjƒÓgren's syndrome. Br. J. Ophthalmol. 58, , Poirier, R. H., Ryburn, F. M. and Israel, C. W: Swimmer's goggles for keratoconjonctivitis sicca. Arch. Ophthalmol. 59, , 1977.
14 Clinical studies on patients with SjƒÓgren's syndrome Part 2 Characteristics of patients with SjƒÓgren's syndrome and the effect of corticosteroid therapy Keiko KAGEYAMA The 3rd Department of Internal Medicine, Okayama University Medical School (Director: Prof. T. Ofuji) We analyzed the clinical and laboratory findings of 160 patients with definite SjƒÓ gren's syndrome, and examined the effect of corticosteroid therapy on these patients. One hundred and fifty nine were female, and the average age at the time of diagnosis was 46.2 }12.2years. The past histories disclosed gynecological diseases in 44 patients (29.9%) and appendicitis in 32 (21.8%); 10 (6.8%) with sinusitis; 10 (6.8%) with pleuritis. Complaints of oral dryness and decreased saliva were common in 73.8% of patients. Fail ure of lacrimation, redness, "film", and increased dental caries were present in 20-30% of patients. In addition, systemic manifestations such as arthralgia, fever, Raynaud's phenomenon, and lymph node swelling were frequent. Abnormalities of Schirmer's test, gum test, histological findings of salivary glands, and of the sialogram were found in 80% of patients. Hyper ƒá-globulinemia was present in 81%. Anti SS-A antibody, rheumatoid factor, and total antinuclear antibodies were positive in 60-70%. Corticosteroid was effective for patients with the sicca syndrome; it relieved the symptoms of dry eye and dry mouth, and also tended to decrease the inflamation of the salivary glands. Serum ƒá-globulin and amylase were lower immediately after the corticosteroid treatment.
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