シェーグレン症候群自験216例における自己抗体と臨床像の検討

Abstract

This study aimed to ascertain the correlation between clinical symptoms and serological abnormalities in patients with Sjögren's syndrome (SS), and to make a comparison between the criteria advocated by Fox et al. (Fox's criteria) with those established by the SS study Group of The Ministry of Health and Welfare (Japanese criteria). The subjects enrolled in this study were 216 patients diagnosed as having SS according to Japanese criteria. Autoantibodies determined in this study were antinuclear antibody (ANA), anti SS-A/Ro antibody, and anti SS-B/La antibody. ANA was detected by indirect immunofluorescence staining method. Anti SS-A/Ro antibody and anti SS-B/La antibody were detected by double immunodiffusion method. ANA was positive in 51.0% of all SS patients, in 40.6% of primary SS, and in 57.1% of secondary SS, respectively. Anti SS-B/La antibody was positive in 16.4% of all SS patients, in 13.8% of primary SS, and in 22.9% of secondary SS, respectively. The patients who exhibited xerophthalmia and/or xerostomia as initial symptoms showed significantly higher incidence of anti SS-A/Ro antibody than the cases which demonstated other initial symptoms. Those cases which demontsrated a focus score of 1 or greater in histological changes of the salivary gland showed significantly higher incidence of positive ANA than cases with a focus score of less than 1. These results indicate that the Fox's criteria are more specific for xerophthalmia and/or xerostomia than Japanese criteria, but Japanese criteria are more specific for the histological changes of the salivary gland than Fox's criteria.