シェーグレン症候群に皮膚結節性多発動脈炎を合併した1例  [in Japanese] A Case of Sjögren’s Syndrome Complicated with Cutaneous Polyarteritis Nodosa  [in Japanese]

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Abstract

70歳,女性。40歳代より眼球結膜の充血と口腔乾燥感を自覚し,65歳でdry eyeを指摘された。70歳時に両下肢に浮腫・潰瘍・疼痛が出現し当科を受診した。乾燥性角膜炎をみとめ,唾液腺造影検査および口唇腺生検の結果よりシェーグレン症候群と診断した。また下腿の生検にて小動脈の壊死性血管炎を認めたことより,シェーグレン症候群に結節性多発動脈炎を合併した稀な症例と考えられた。

We report a case of 70-year-old woman with Sjögren’s syndrome whom it was thought to be associated with cutaneous polyarteritis nodosa.<BR>She developed a gradual progression of dry mouth after partial replacement of her teeth at the age of 45 years. She presented in 1996, at the age of 65, with three year history of dry eyes. In June 2001, she was aware of edema and pain in both lower legs. At the same time, indurated erythemas and ulcers are seen on her lower legs. Pain, erythemas and ulcers expanded, and she was admitted to our hospital in September, 2001.<BR>Lip biopsy revealed infiltration of lymphocytes in the salivary glands. Schirmer test was positive and sialography revealed marked destructive changes in the acinus lobules. These features justified the diagnosis of Sjögren’s syndrome.<BR>Laboratory data revealed positive anti-SS-A antibodies and absence of MPO-ANCA. Rheumatoid factor was positive, and anti-nuclear antibody was × 640 (speckled type).<BR>Biopsy from the skin lesion disclosed leukocytoclastic vasculitis of small arteries in the fat tissue.<BR>Neurological examination revealed mononeuritis multiplex. These findings were compatible with the diagnosis of polyarteritis nodosa.

Journal

  • Hifu no kagaku

    Hifu no kagaku 2(5), 448-452, 2003

    Meeting of Osaka Dermatological Association/Meeting of Keiji Dermatological Association

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