干燥综合征鼻部表现

Nasal manifestations of Sjogren’s syndrome

1病例资料患者,女,43岁,2018年12月11日以"鼻部干燥、刺痛5个月"为主诉入院。患者2018年7月无明显诱因出现鼻腔干燥、鼻部持续刺痛,未特殊治疗;2018年8月鼻腔干燥、刺痛症状较前加重,伴随眼干、口干症状,并相继出现发热、进食需饮水辅助等症状,体温波动在37~39℃;2018年9月除上述症状外又出现呼吸困难、张口呼吸症状。入院查体:双侧鼻腔狭窄,鼻中隔前端黏膜肿胀,口腔黏膜干燥、草莓舌,既往无特殊。

We reported a case of a 43-year-old female patient with nasal Sjogren’s syndrome(SS).She complained of dry and tingling nose for 5 months.Physical examination:bilateral nasal stenosis,swelling of the mucosa at the front of the nasal septum,dry oral mucosa,and strawberry tongue.Sinus CT showed:bilateral nasal cavity stenosis,nasal septal mucosa and bilateral nasal mucosa hypertrophy.Salivary gland dynamic imaging:the maximum excretion percentage of the left salivary gland is 4.05%,and the maximum excretion percentage of the right salivary gland is 1.81%.Labial gland biopsy showed that the salivary gland lobular structure existed,and multiple lymphocyte foci(>50/each foci)were seen in the focal interstitium,which was consistent with the labial gland performance of SS.Immunohistochemistry showed:CD3+,CD20+,AE1/AE3+,Ki-67+,IgG+.After symptomatic treatment,the patient’s dry nose and tingling symptoms disappeared.The swelling of the nasal mucosa disappeared,and the bilateral nasal cavity was well ventilated.Follow-up for half a year,no symptoms of nasal manifestations about Sjogren’s syndrome has occurred.