乾躁症，硬皮症，皮肌炎

1.Sjogren's syndrome乾躁症

• 得B-cell lymphoma的機率↑40倍
• 會出現Raynaud's syndrome
• 最常見的腺體外症狀是多發性關節炎(oligoarthritis)
• Primary Sjogren's syndrome=乾燥+腺體外症
• Second Sjogren's syndrome=乾燥+腺體外症+其他自體免疫疾病
• thrombocytopenia，80%hypergammabulinemia，10%leukopenia

Gland function examination

• eye=Shirmer's tear test(試紙)/Rose Bengal staining(染劑)
• 唾液=Scintigraphy(核醫)
• Minor salivary gland biopsy最準→>50 lymphocytes/4mm2

• 要排除HCV，AIDS
• 服用cholinergic agonist=pilocarpine，但是，會有bronchospasm，asthma病人避免服用
• 腺體外疾病可用corticosteriod

2.全身性硬化症(Systemic sclerosis)

• 集中在皮膚及內臟
• 膠原蛋白分泌量過多
• anti-centromere & anti-Scl-70

ESR CRP
PSjogren ↑ ─(↑if infection)
SLE ↑ ─
RA ↑ ↑