シェーグレン症候群に関する臨床的研究 第二編 シェーグレン症候群の臨床像とステロイド療法に関する研究

We analyzed the clinical and laboratory findings of 160 patients with definite Sjogren'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±12.2 years. 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. Failure 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 γ-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 γ-globulin and amylase were lower immediately after the corticosteroid treatment.