ABSTRACT
Primary Sj(o)gren' s Syndrome (pSS)is a chronic autoimmune disease with complex and diverse clinical manifestations.It is characterized by lymphocyte infiltration of exocrine glands such as the salivary gland and lacrimal gland leading to insufficient secretion of the gland,manifested as dry mouth and dry eyes.The disease in addition to exocrine glands cause damage,but also involving organs outside the gland,resulting in systemic systemic injury.The pathogenesis of pSS is not clear yet.Currently,symptomatic treatment is the mainstay of pSS,and the exact treatment is lacking.However,there are some new treatments in recent years.
ABSTRACT
Primary Sj(o)gren's syndrome (pSS) is a chronic autoimmune disease characterized by lymphoplasmacytic infiltration of the exocrine glands that results in multiple organs and systems damage.Renal injury affects 0.3％-27.0％ patients,The most frequent form of nephropathy in pSS is tubulointerstitial nephritis.The main clinical manifestation is renal tubular acidosis.The renal prognosis in patients with pSS is usually favorable,but renal failure may occur.At present,it still lacks of strict consensus or guideline for the treatment.
ABSTRACT
Objective To explore the relationship between the clinical features,serological markers and European League Against Rheumatism SS Disease Activity Index (ESSDAI) scores of primary Sj(o)gren's syndrome (SS).Methods We enrolled 106 patients,who fulfilled the 2002 classification criteria for primary SS from December 2008 to January 2015,to evaluate the relationship among the clinical characteristics,laboratory features,serological variables and ESSDAI scores.According to serological variables,the prognosis was subdivided into three distinct groups:favourable (no serological markers),intermediate (one serological marker) and poor (two or more serological markers).These data were analyzed by Chi-square test and variance analysis.Results The mean ESSDAI score of 106 pSS patients was (11±7).ESSDAI score was categorized according to the EULAR-SS recommendations as low activity,moderate activity and high activity (scores of 0-4,5-13 and ≥14,respectively),and the positive rate of antinuclear antibody (ANA) 1:100 (6 cases,37.5％;37 cases,66.1％;32 cases,94.1％) in three different ESSDAI levels was statistically different (x2＝18.110,P＜0.01).Those with positive ANA 1:100[positive (13±7) and negative (7±4)],anti-SSA antibody postive (12±7) and negative (9±7),anti-RNP antibody (positive 16±9 and negative 10±6) had higher ESSDAI scores than those with negative ones (F=8.812,P=0.0001;F=3.862,P=0.024;F=5.786,P=0.004).No statistical difference in ESSDAI means were found between patients with positive anti-SSB antibody,rheumatoid factor (RF),FS level,dry mouth,Raynoud's phenomenon and psychosomatic diseases.The ESSDAI scores of favourable group,intermediate group and poor group were significantly different (8±5,10±7,14±7,F=8.715,P=0.000 1).In comparison with the other two groups,the poor pSS patients had a higher frequency of positive ANA 1:100 (15 cases,55.6％;20 cases,57.1％;40 cases,90.9％),anti-SSA antibody(11 cases,0.7％;23 cases,41.1％;36 cases,81.8％),anti-SSB antibody (6 cases,2 2.2％;13 cases,37.1％;23 cases,52.3％),anti-RNP antibody (0 case,0;2 cases,5.7％;9 cases,20.5％) (x2=17.408,P=0.002;x2=14.306,P=0.006;x2=12.330,P=0.015;x2=1 1.482,P=0.022).Conclusion Patients with two or more serological markers may have higher ESSDAI score,and which in turn may associate with poor prognosis.
ABSTRACT
This study aimed at exploring the features of the body constitution and syndrome types of TCM in patients with pSS.General information of 60 patients with pSS was collected.Their TCM syndrome types and TCM body constitution types were examed,while the distribution of pSS syndrome types in terms of their body constitution was analyzed.Among 60 pSS patients,58 of them (96.67％) were female with the average age of 52 years and an average course of 63 months.Their usual residence was Xinjiang.Their most common first symptoms included thirst,dry eyes and joint pain,and the damage of skin and mucous membranes and blood system was rare.It was found that the syndrome of both qi and yin deficiency was the most common (48.33％),followed by the impregnation syndrome of heat and dampness (26.67％) and the syndrome of the weakness of spleen qi (25％) in pSS patients.Yin deficiency (58.33％) and yang deficiency (58.33％) in the body constitution of TCM accounted for decent proportions,followed by the constitutions of qi stagnation (48.33％),qi deficiency (45.00％),blood stasis (38.33％),phlegm-dampness (36.67％),damp-heat (18.33％),allergic (13.33％) and yin-yang harmony (1.67％).Those without the health education of pSS accounted for 51.11％ in cases of palindromia.In conclusion,yin deficiency and yang deficiency constitutions were most common,at most,the body constitution of both qi and yin deficiency,in pSS patients in accordance with TCM body constitution.Most pSS patients of palindromia didn't received professional health education of pSS.All the causes above suggested that we should make individualized treatment programs according to clinical syndrome types and the characteristics of TCM body constitution in pSS patients for strengthening the health management of pSS and improving their quality of life.
ABSTRACT
Objective To explore the clinical characteristics of thyroid disease in patients with primary Sj(o)gren's syndrome (pSS).Methods A total of 81 pSS patients were retrospectively investigated for thyroid dysfunction and the presence of anti-thyroid peroxidase antibody (TPOAb),antithyroglobulin antibody (TGAb).Sex,age,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),white blood cell count,and serum immunoglobulins were also analyzed.Results Thirty-one patients were identified as having thyroid dysfunction,including 3 with hyperthyroidism,18 with hypothyroidism,and 10 with subclinical hypothyroidism.There were no significant differences in the incidences of some clinical manifestations between patients with or without thyroid dysfunction,such as dry mouth,dry eyes,joint pain,Raynaud's phenomenon,palpable purpura,peripheral neuropathy,interstitial lung disease,liver involvement,and renal tubular acidosis.Differences were not statistically significant for ESR and CRP between two groups.Also,the titers of anti-nuclear antibody,anti-SSA antibody,antiSSB antibodies,and rheumatoid factor between two groups showed no significant differences.However,white blood cell count [(5.65 ± 0.49 vs 7.22 ± 0.48) × 109/L,P＜0.05] and hematoglobin [(110.50 ± 3.64 vs 122.80 ± 3.02) g/L,P＜0.05],as well as the titers of TGAb [(587.30 ± 204.30 vs 58.76 ± 13.78) U/ml,P＜0.05] and TPOAb [(213.70 ± 39.64 vs 29.57 ± 8.49) IU/ml,P ＜ 0.05] were significantly different between the two groups.Conclusions Thyroid diseases are frequently associated with pSS.Therefore,extended screening for existing thyroid diseases during the routine assessment of pSS patients is recommended.
ABSTRACT
Objective To investigate the clinical and laboratory characteristics of anticentromere antibody (ACA)and anti-SSA antibody expressions in patients with Primary Sj(o)gren's Syndrome (PSS). Methods Twelve PSS patients with ACA positive but SSA negative(ACA PSS)and 19 PSS patients with SSA positive but ACA negative(SSA PSS)were enrolled into the study and classified into two groups. We compared the age,laboratory data,occurrence of Raynaud's phenomenon(RP),and histological changes in minor labial salivary glands biopsies of the patients from two group. Results The mean age of the ACA PSS group(68.4 ± 7.9)years was significantly higher than that of the SSA PSS(54. 6 ± 16. 2)years group(P ＜ 0. 05). Serum IgG level of ACA PSS group(17. 89 ±4. 08)g/L was close to the normal range,which was significantly lower than that of SSA PSS(27.90 ±6. 72)(P ＜0. 01). Leukocytopenia was less frequently observed in ACA PSS than in SSA PSS(P ＜ 0. 05),the difference between two groups was statistically significant. We also found more frequent RP in the ACA PSS group than SSA PSS group(P ＜ 0. 05). Conclusions Our data confirm that ACA positive PSS differs from SSA positive PSS at several clinical respects and laboratorial examinations.
ABSTRACT
Objective To detect anti-M3 receptor antibodies in primary Sj(o)gren's syndrome(pSS)patients and to explore its association with clinical manifestations.Methods Anti-M3 antibodies were tested in 70 patients with pSS,50 patients with systemic lupus erythematosus(SLE)and 76 normal controls with ELISA and Western blot.The correlation between anti-M3 antibodies and other clinical manifestations was analyzed.Results (1)The positive rate of anti-M3 antibodies in pSS Was 47.14% using ELISA and 60.00% using Western blot in SLE 4.00% using ELISA and 12.00% using Western blot and in normal controls 14.47% using ELISA and 15.79% using Western blot.(2)The incidence of sehirmer test,tear break-up time(BUT),whole saliva flow rate,punctate epithelial erosions(PEE)on the corneas and external eye examination were not significantly different between the anti-M3 positive and negative groups.(3)The incidences of IgG,rheumatoid factor,SSB and fluorescence index(FI)＞3 were higher in the positive group than in the negative group using EUSA.Conclusion The positive rate of anti-M3 antibodies is higher in pSS than in SLE and normal controls and in some degree it has correlation with the lesion in salivary gland.