Sjögren syndrome

Sjögren syndrome yog qhov mob autoimmune uas nyob hauv cov qog uas tsim kua muag thiab qaub ncaug puas tsuaj. Qhov no ua rau lub qhov ncauj qhuav thiab qhov muag qhuav. Tus mob yuav cuam tshuam lwm qhov ntawm lub cev, suav nrog ob lub raum thiab lub ntsws.

Qhov ua rau Sjögren syndrome tsis paub meej. Nws yog qhov mob autoimmune. Qhov no txhais tau tias lub cev tawm tsam cov nqaij noj qab haus huv los ntawm kev ua yuam kev. Tus mob no tshwm sim ntau rau cov poj niam hnub nyoog 40 txog 50. Nws yog tsawg rau cov me nyuam.

Thawj tus mob Sjögren syndrome txhais tias yog lub qhov muag qhuav thiab lub qhov ncauj qhuav tsis muaj lwm qhov tsis meej autoimmune.

Secondary Sjögren syndrome tshwm sim nrog rau lwm cov kev muaj mob autoimmune, xws li:

• Kev mob caj dab (RA)
• Txheej txheem lupus erythematosus
• Scleroderma
• Polymyositis
• Kab mob siab C tuaj yeem cuam tshuam cov qaub ncaug salivary thiab zoo li Sjögren syndrome
• Tus kab mob IgG4 tuaj yeem zoo li Sjogren syndrome thiab yuav tsum raug txiav txim siab

Qhov muag qhuav thiab qhov ncauj qhuav yog qhov tshwm sim zoo tshaj plaws ntawm tus mob no.

Cov tsos mob qhov muag:

• Khaus lub qhov muag
• Hnov tej yam nyob hauv yus lub qhov muag

Cov tsos mob ntawm lub qhov ncauj thiab lub caj pas:

• Nyuaj yooj yim nqos lossis noj zaub mov qhuav
• Plam qhov tsis hnov ​​qab
• Teeb meem hais lus
• Ua qaub ncaug los sis qaub ncaug
• Qhov ncauj mob los yog mob
• Cov hniav lwj thiab pos hniav mob
• Khuam

Lwm cov tsos mob tuaj yeem suav nrog:

• Nkees
• Ua npaws
• Hloov xim ntawm txhais tes lossis taw nrog lub pob txias (Raynaud phenomenon)
• Mob pob qij txha los yog o ua ke
• Cov qog ntshav tawm
• Cov tawv nqaij ua pob
• Loog thiab mob vim yog mob neuropathy
• Hnoos thiab txog siav ua tsis taus pa vim yog kab mob ntsws
• Lub plawv dhia tsis xwm yeem
• Xeev siab thiab kub siab
• Vaginal dryness lossis tso zis mob

Kev kuaj mob thoob plaws lub cev yuav ua tiav. Qhov kev kuaj mob nthuav tawm qhov muag qhuav thiab lub qhov ncauj qhuav. Tej zaum yuav muaj qhov ncauj tawm, mob hniav lossis pos hniav. Qhov no tshwm sim vim yog lub qhov ncauj dryness. Koj tus kws kho mob yuav saib hauv koj lub qhov ncauj txog tus kab mob fungus (candida). Cov tawv nqaij yuav pom tawm pob xoo, kev kuaj lub ntsws yuav txawv txav, lub plab yuav palpated rau daim siab ua haujlwm. Cov pob qij txha yuav raug kuaj rau mob caj dab. Qhov kev kuaj mob neuro yuav saib rau qhov tsis muaj dab tsi.

Koj tuaj yeem ua cov hauv qab no:

• Ua tiav cov ntshav chemistry nrog lub siab enzymes
• Ua tiav cov ntshav suav nrog kev sib txawv
• Mob Lub Hlaus
• Cov tshuaj tiv thaiv kev ua kabmob (ANA)
• Anti-Ro / SSA thiab tshuaj tiv thaiv La / SSB
• Qhov zoo tshaj yuav Rheumatoid
• Kev sim tshuaj rau cryoglobulins
• Sib txuam sib luag
• Protein electrophoresis
• Kuaj mob rau daim siab C thiab HIV (yog tias muaj pheej hmoo)
• Kev ntsuam xyuas cov thyroid
• Kev ntsuam xyuas tsim kua muag ntawm Schirmer
• Kev ntsuas qog ua kua qab ntsev: los ntawm ultrasound lossis los ntawm MRI
• Mob rau lub qog noj su
• Siv daim tawv nqaij los so yog tias muaj pob
• Kev soj ntsuam ntawm lub qhov muag los ntawm tus kws kho qhov muag
• Kev ntsuas hluav taws xob xoo

Lub hom phiaj yog daws cov tsos mob.

• Qhov muag qhuav yuav tau kho nrog kua muag cuav, pleev tshuaj pleev qhov muag, lossis kua cyclosporine.
• Yog tias Candida muaj nyob, nws tuaj yeem kho cov kua qab zib tsis muaj miconazole lossis nystatin npaj.
• Cov txhav me me tuaj yeem tso rau hauv lub qhov muag pleev tawm kom pab cov kua muag nyob twj ywm ntawm qhov muag.

Kab mob hloov kho cov tshuaj antirheumatic (DMARDs) zoo ib yam li cov tshuaj uas siv rau RA yuav txhim kho cov tsos mob ntawm Sjögren syndrome. Cov no suav nrog cov qog necrosis factor (TNF) inhibiting cov tshuaj xws li Enbrel, Humira lossis Remicaide.

Qee yam koj tuaj yeem ua kom yooj yim cov tsos mob muaj xws li:

• Quav dej thoob plaws ib hnub
• Zom cov khaub noom tsis muaj suab thaj
• Zam kev tshuaj uas tuaj yeem ua rau lub qhov ncauj qhuav, xws li antihistamines thiab decongestants
• Zam txhob haus cawv

Tham nrog koj tus kws kho hniav txog:

• Lub qhov ncauj yaug dej los hloov cov zaub mov hauv koj cov hniav
• Qaub ncaug hloov
• Cov tshuaj uas pab koj cov qaub ncaug ua rau muaj qaub ncaug ntau dua

Txhawm rau tiv thaiv hniav lwj ua rau qhov ncauj qhuav:

• Txhuam thiab siv hlua dig koj cov hniav ntau
• Mus ntsib kws kho kaus hniav kuaj hniav thiab tu huv si

Tus kabmob yog feem ntau tsis rau lub neej. Qhov tshwm sim nyob ntawm seb koj muaj lwm yam kab mob dab tsi.

Muaj kev pheej hmoo siab rau mob qog nqaij hlav thiab mob thaum ntxov thaum Sjögren syndrome tau ua haujlwm ntev heev, nrog rau cov neeg muaj vasculitis, ua kom tsis tiav, thiab cryoglobulins.

Teeb meem yuav suav nrog:

• Puas tsuaj rau lub qhov muag
• Cov hniav kab noj hniav
• Raum tsis ua haujlwm (tsawg)
• Lymphoma
• Kab mob ntsws
• Vasculitis (tsawg)
• Neuropathy
• Lub zais zis o

Hu rau koj tus kws kho mob yog tias koj muaj tus mob Sjögren syndrome.

Xerostomia - Sjögren syndrome; Keratoconjunctivitis sicca - Sjögren; Sicca cov tsos mob

• Tshuaj tua kabmob

Baer AN, Alevizos I. Sjögren syndrome. Hauv: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Pob tsuasCov. 7 tus ed. Philadelphia, PA: Elsevier; 2019: chap 147.

Mariette X. Sjögren syndrome. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 268.

Seror R, Bootsma H, Saraux A, li al. Kev txhais cov haujlwm kev ua haujlwm ntawm lub xeev thiab kev kho mob muaj txiaj ntsig zoo hauv thawj tus mob Sjögren's syndrome nrog EULAR thawj Sjögren's syndrome cov kab mob (ESSDAI) thiab cov neeg mob qhia txog cov cim (ESSPRI). Ann Rheum DisCov. 2016; 75 (2): 382-389. PMID: 25480887 www.ncbi.nlm.nih.gov/pubmed/25480887.

Singh AG, Singh S, Matteson EL. Tus nqi, cov teeb meem pheej hmoo thiab ua rau muaj kev tuag nyob rau hauv cov neeg mob uas Sjögren's syndrome: kev soj ntsuam ib qho kab ke hauv nruab nrog cev thiab kev soj ntsuam ntawm kev kawm tshawb xyuas. Rheumatology (Oxford)Cov. 2016; 55 (3): 450-460. PMID: 26412810 www.ncbi.nlm.nih.gov/pubmed/26412810.

Turner MD. Qhov ncauj ua mob ntawm cov kab mob. Hauv: Flint PW, Haughey BH, Lund V, li al, eds. Cummings OtolaryngologyCov. 6 tus ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 14.