[研究新知介紹]
修格蘭氏症(Sjögren's syndrome) 與其他疾病之口乾、眼乾鑑別診斷
我覺得這篇法國回顧性研究修格蘭氏症(Sjögren's syndrome) 與其他疾病之口乾、眼乾鑑別診斷，滿值得一看的，可以知道不是只有乾燥症才是口乾眼乾，也不是口乾眼乾就是乾燥症，一般俗稱的乾燥症其實是Sicca complex，也就是口眼乾燥症候群，成因有很多，比如：用眼過度、說話過多、藥物副作用、利尿劑引起，甚至是糖尿病、更年期、癌症放射線療法或是化療，Sicca complex跟Sjögren's syndrome是不一樣的，但目前很多人常常把概念搞錯，所以本篇作者再最後也總結對Sjögren's syndrome臨床上需要觀察的SOAP要點。
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摘錄自Clinical Reviews in Allergy & Immunology研究成果：
The Differential Diagnosis of Dry Eyes, Dry Mouth, and Parotidomegaly: A Comprehensive Review.
Cornec D1,
Saraux A,
Jousse-Joulin S,
Pers JO,
Boisramé-Gastrin S,
Renaudineau Y,
Gauvin Y,
Roguedas-Contios AM,
Genestet S,
Chastaing M,
Cochener B,
Devauchelle-Pensec V.
- 1Department of Rheumatology, Brest Teaching Hospital, Brest, France.
Abstract
Primary Sjögren's syndrome (pSS) is a frequent autoimmune systemic disease, clinically characterized by eyes and mouth dryness in all patients, salivary gland swelling or extraglandular systemic manifestations in half of the patients, and development of lymphoma in 5 to 10 % of the patients. However, patients presenting with sicca symptoms or salivary gland swelling may have a variety of conditions that may require very different investigations, treatments, or follow-up. Eye and/or mouth dryness is a frequent complaint in clinical setting, and its frequency increases with age. When evaluating a patient with suspected pSS, the first step is to rule out its differential diagnoses, before looking for positive arguments for the disease. Knowledge of normal and abnormal lachrymal and salivary gland physiology allows the clinician to prescribe the most adapted procedures for evaluating their function and structure. New tests have been developed in recent years for evaluating these patients, notably new ocular surface staining scores or salivary gland ultrasonography. We describe the different diagnoses performed in our monocentric cohort of 240 patients with suspected pSS. The most frequent diagnoses are pSS, other systemic autoimmune diseases, idiopathic sicca syndrome and drug-induced sicca syndrome. However, other diseases are important to rule out due to their specific management, such as sarcoidosis, granulomatosis with polyangeitis, IgG4-related disease, chronic hepatitis C virus or human immunodeficiency virus infections, graft-versus-host disease, and head and neck radiation therapy. At the light of these data, we propose a core of minimal investigations to be performed when evaluating a patient with suspected pSS.
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