ABSTRACT
The clinicofunctional and morphological status of the stomach, biliferous system, pancreas, large and small intestine was studied in 83 patients with Sjogren's syndrome and disease (SS and SD). Chronic gastritis with secretory insufficiency was shown to develop in SD. Morphological changes of the gastric mucosa were represented by chronic gastritis with glandular involvement and chronic atrophic gastritis of immune genesis. Pathology of the extrahepatic system of bilification was detected in 87% of patients. The most common pathologies diagnosed in these patients were chronic cholecystitis (51%) and biliary dyskinesia (25%). Changes of the chemical composition of the bile (arise of its lythogenic properties) were observed. Various disorders of pancreatic function were detected in 85% of SS and SD patients. X-ray and endoscopic investigations revealed duodenal, intestinal and colon hypokinesia, less frequently signs of enteritis and colitis in one-third of the patients. The irritable colon syndrome was found in 40%. On the whole, involvement of different parts of the intestine was observed in 92%. Morphological changes in the duodenal and sigmoid colon mucosa were typical of chronic diffuse duodenitis and sigmoiditis in a subacute SD course, and chronic atrophic duodenitis and sigmoiditis in a chronic SD and SS course.
Subject(s)
Digestive System Diseases/etiology , Digestive System/physiopathology , Sjogren's Syndrome/complications , Adult , Aged , Digestive System/pathology , Female , Humans , Male , Middle Aged , Sjogren's Syndrome/pathology , Sjogren's Syndrome/physiopathologySubject(s)
Bile/analysis , Gallbladder Diseases/diagnosis , Sjogren's Syndrome/complications , Adult , Aged , Chronic Disease , Female , Humans , Male , Middle AgedABSTRACT
Stomach secretory function and gastrin concentration in the blood serum were studied in 45 patients with Sjögren's disease. A sharp decrease in acid- and enzymoforming function of the stomach, disorder of the process of mucus formation and hypergastrinemia were detected in 80% of the patients. The relationship of stomach secretory function, gastrin concentration and the gravity of xerostomia was established. Morphology of the mucosa of the body and antral part of the stomach revealed chronic atrophic gastritis. Massive lymphohistiocytic infiltration of the mucous membrane with focal aggregations of lymphoid elements, atrophy and destruction of the glands were revealed. B-lymphocytes prevailed in the cellular infiltrate. T-lymphocytes were found in a small amount among the infiltrate cells and epithelial cells of the main gastric glands.
Subject(s)
Gastric Mucosa/metabolism , Sjogren's Syndrome/physiopathology , Adult , Aged , Female , Gastric Acid/metabolism , Gastric Mucosa/pathology , Gastrins/metabolism , Humans , Male , Middle Aged , Pepsin A/metabolism , Sjogren's Syndrome/pathologyABSTRACT
Sixty patients with Sjogren's disease (SD) were examined. In all the patients--women aged 23 to 70, apart from the generalized "dry syndrome", there were signs of involvement of other organs and systems. Biopsy and autopsy material was studied histologically and histochemically, in some cases immunofluorescent and electron-microscopical study was performed. The most pronounced morphological and clinical manifestations of SD were linked with the damage to exocrine glands. Their alterations were represented by delayed type hypersensitivity and were similar in all exocrine glands, hence the exocrine tissue might be regarded as a target tissue in SD. One of the mechanisms of the exocrine tissue damage is connected with a mutual duct antigen of exocrine glands represented by the serum component IgA. The involvement of certain organs and systems with the development of chronic persistent hepatitis, fibrosing alveolitis, mesangioproliferative and tubulointerstitial nephritis, pronounced hyperplasia of lymphoid tissue with its plasmatization and generalized affection of the microcirculatory system of the immunocomplex nature, is noted in SD with various frequency.
