I. What is desiccation syndrome?
Dry syndrome is a systemic autoimmune disease with dry mouth and eyes as the main clinical manifestation, which can be divided into primary dry syndrome and secondary dry syndrome, the latter is secondary to other autoimmune diseases. The ratio of men to women is 1:9, mostly seen in women at menopause and after, and it can be accompanied by repeated parotid enlargement, rampant dental caries and multi-organ damage.
What factors are related to the onset of dry syndrome?
The etiology of dry syndrome is not yet clear, it may be related to genetics, immunity, viral infection and sex hormone level.
1.Genetic factors: Patients have family aggregation, and patients have high frequency of HLA-DR3, HLA-B8 and HLA-DRw52 genes.
2, viral infection: now it is thought to be related to EBV, cytomegalovirus, coxsackievirus type B4, hepatitis B virus, hepatitis C virus and HIV virus infection.
3.Sex hormone: the incidence rate of women is obviously higher than that of men, and it occurs mostly in menopausal women, suggesting that sex hormone may be involved in the development of dry syndrome.
What are the exocrine gland manifestations of dry syndrome?
1.Expression of dry mouth: dry mouth, dry tongue, dry and cracked tongue, mirror tongue, need to drink water when talking and eating solid food, repeated oral ulcers, rampant dental caries and repeated swelling of parotid gland and submaxillary gland.
2. Dry eye signs: dry eyes, photophobia, few tears, foreign body sensation, and even no tears. Ophthalmia often occurs, and there is often filiform discharge from the inner canthus of the eye.
Other exocrine gland manifestations: dryness of nasal cavity, throat and trachea; reduced gastric acid, atrophic gastritis, subclinical pancreatitis, dry skin and vaginal dryness.
4.What are the systemic manifestations of dry syndrome?
Analyzing the clinical investigation of more than 10 large-scale dry syndrome patients abroad, we summarized the clinical manifestations and systemic involvement of the disease, except for the dryness of the mouth and eyes.
V. What are the laboratory tests specific for the diagnosis of dry syndrome?
There are many kinds of autoantibodies in the serum: including positive rheumatoid factor and positive antinuclear antibody with low specificity, anti-SSA antibody, anti-SSB antibody, a-cytosolic protein antibody and M3 receptor antibody with high specificity, etc.
What is the significance of lip gland biopsy and parotid gland imaging on the diagnosis of dry syndrome?
The diagnostic standard of dry syndrome has not been unified yet. Lip gland biopsy and parotid gland imaging are two important bases among the four objective evidences for the diagnosis of dry mouth syndrome, so they have very important significance for the diagnosis of dry syndrome. If the pathology of the labial gland shows that there are focal lymphocyte infiltration >50 cells/mm2 in the gland, it has diagnostic significance.
How to diagnose dry syndrome?
At present, there are many diagnostic criteria for dry syndrome, which have not been unified. 2012, the latest diagnostic criteria for dry syndrome proposed by American Rheumatism Association include
1.positive anti-SSA and/or anti-SSB antibodies, or positive rheumatoid factor accompanied by anti-nuclear antibodies ≥1:320.
2, corneal staining score ≥ 3.
3, focal lymphocytic infiltration >50 lymphocytes/4mm2 on lacrimal gland pathology. 2 or more of the above 3 items can be diagnosed. The specificity of this criterion is greatly improved. In addition, the history of head, face and neck radiotherapy, hepatitis C virus infection, AIDS, nodular disease, amyloidosis, GVH disease and IgG4-related diseases must be excluded before diagnosing dry syndrome.
Which diseases should be distinguished from dry syndrome?
These drugs include anticholinergic drugs, diuretics, diabetic, diabetic, hepatitis B, hepatitis C, etc. When dry syndrome is mainly caused by a certain system damage, attention should be paid to differentiate from related diseases.
IX. What are the main drugs for the treatment of dry syndrome?
The drugs for dry syndrome are mainly divided into two categories: symptomatic drugs and systemic treatment drugs. The former includes artificial tear solution, Bixupine, Mucosolvan, cyclopentethione, non-steroidal anti-inflammatory drugs, potassium preparations and traditional Chinese medicine for the production of fluids, etc. When vasculitis and multi-system damage of lung, kidney, nerve and blood appear in dry syndrome, systemic treatment drugs such as total glucoside of peony, hydroxychloroquine, glucocorticoid and immunosuppressant (such as leflunomide, azathioprine, methotrexate, etc.) can be used according to the condition.
X. Can dry syndrome be completely relieved?
If patients with desiccation syndrome can be diagnosed at an early stage, a regular and systematic treatment plan can be formulated according to the presence or absence of organ involvement, and glucocorticoids and immunosuppressants can be used correctly, most patients can be in complete remission.