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한국인 일차성 쇼그렌 증후군 환자의 선외 임상상의 분석
최병용 ( Byoong Yong Choi ),유종진 ( Jong Jin Yoo ),오혜진 ( Hye Jin Oh ),장유진 ( Yu Jin Jang ),이윤종 ( Yun Jong Lee ),송영욱 ( Yeong Wook Song ) 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.3
Objectives. To investigate the clinical findings upon initial diagnosis and extraglandular manifestations in Korean patients with primary Sjogren``s syndrome (pSS). Methods. We collected clinical and laboratory data from 238 pSS patients enrolled at Seoul National University Hospital, Seoul National University Bundang Hospital and Seoul Medical Center from March 2011 to December 2014. All patients met the American-European Consensus Group criteria for pSS. Results. Upon initial diagnosis, sicca symptoms (xerophthalmia or xerostomia) as the chief complaint were only observed in 129 (54.2%) pSS patients, while extraglandular manifestation was more common as the chief complaint in male patients or those with younger age (<40 years) than female or older patients (both p<0.05). Extraglandular manifestations were found in 178 (74.8%) patients, with musculoskeletal manifestations being most common (53.8%). Peripheral neuropathy in pSS patients was associated with Raynaud phenomenon and elevated serum total immunoglobulin G (IgG) levels (both p<0.05). Serum β2-microglobulin (β2-M) levels were significantly correlated with European League against Rheumatism (EULAR) Sjogren``s syndrome disease activity index, erythrocyte sedimentation rate and serum total IgG (all p<0.001), and were higher in patients with extraglandular manifestations than those without (p<0.05). Serum C3 levels were decreased in patients with extraglandular manifestation, compared to those without (p<0.05). Malignant lymphoma was found in Korean pSS patients (1.7%) and associated with elevated serum β2-M levels (p<0.0001). Conclusion. Extraglandular manifestations were common in pSS patients and may be a diagnostic tool for male or younger pSS patients. Serum β2-M levels can be useful markers for monitoring pSS patients. (J Rheum Dis 2015;22:167-174)