Sjoumlgrens综合征中的干

Sj?gren’s综合征中的干燥性角膜结膜炎KeratoconjunctivitisSiccainSj?gren’sSyndrome_NEJM音频听写

Ourimageinclinicalmedicinefeaturesa64-year-oldwomanwhopresentedtotherheumatologyclinicwitha5-monthhistoryofphotophobiawithocularpainandaforeign-bodysensationinbotheyes.Onfurtherquestioning,thepatientreportedthatshehadhaddryeyesanddrymouthforapproximately20yearswithoutaspecificdiagnosisortreatment.Thevisualacuitywas20/25ineacheye,andslit-lampexaminationshowedconjunctivalhyperemia,cornealepithelialerosions,andcornealendothelialfoldsconsistentwithkeratoconjunctivitissiccainbotheyes.Schirmertestingshowedreducedaqueoustearproduction,andserologictestingshowedanantinuclearantibodytiterof1:,withantibodypositivityfortheextractablenuclearSj?gren’ssyndrome–relatedantigenAaswellasanelevatedrheumatoidfactorof66IUpermilliliter.AdiagnosisofSj?gren’ssyndromewasmade,andtreatmentfortheocularsymptomsincludedtopicalcyclosporineAandartificialtears.Thesymptomsresolvedafter2months.

临床医学图片刊载了一名64岁女性，因双眼痛伴双眼异物感5个月于风湿病科就诊。患者诉眼干及口干约20年未行诊治。双眼视力分别为20/25，裂隙灯检查显示双眼结膜充血、角膜上皮糜烂和角膜内皮折叠，这些为干燥性角膜结膜炎的特征性表现。Schirmer试验显示泪液产生减少，血清学检测结果：抗核抗体效价为1：，对Sj?gren综合征相关抗原A呈阳性反应，且类风湿因子升高至66IU/ml。诊断为干燥综合征，予以双眼外用环孢霉素A和人工泪液治疗。2个月后患者症状消失。

资料选自

YutongSu,M.D.,andChengdeYang,M.D.NEnglJMed;:

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