RESUMO
Both Sjögren's syndrome (SS) and non-Sjögren's syndrome (NSS) can present with the sicca symptoms of dry eyes and a dry mouth but they are distinct pathological entities that require diagnostic discrimination. This study included 82 sicca syndrome patients and examined the ability of sialoscintigraphy and antibodies against the autoantigens alpha-fodrin, Ro and La to discriminate between SS and NSS. A total of 30.8% of SS patients compared with 58.8% of NSS patients were alpha-fodrin positive. The prevalence of Ro positivity was 69.4% for SS patients compared with 0% for NSS patients. The prevalence of La positivity was 52.4% for SS compared with 0% for NSS patients. Sialoscintigraphy showed that more NSS patients had grade III salivary gland impairment compared with SS patients (64.7% versus 19.4%). These data suggest that using sialoscintigraphy in combination with measuring the levels of serum alpha-fodrin, Ro and La might be useful for SS and NSS discrimination.
Assuntos
Autoanticorpos/imunologia , Cintilografia/métodos , Glândulas Salivares/patologia , Síndrome de Sjogren/diagnóstico , Xeroftalmia/diagnóstico , Autoantígenos/análise , Autoantígenos/sangue , Autoantígenos/imunologia , Biomarcadores/sangue , Proteínas de Transporte/imunologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Proteínas dos Microfilamentos/imunologia , Pessoa de Meia-Idade , Ribonucleoproteínas/análise , Ribonucleoproteínas/imunologia , Glândulas Salivares/diagnóstico por imagem , Síndrome de Sjogren/imunologia , Xeroftalmia/imunologia , Antígeno SS-BRESUMO
OBJECTIVE: To investigate the influence of hyperglycaemia on deep neck infection (DNI) and the differences between the diabetic and non-diabetic form of DNI. STUDY DESIGN AND SETTING: Retrospective review of 131 patients with DNI treated between 1993 and 2002 at Shin Kong Memorial Hospital, Taipei, Taiwan. RESULTS: Deep neck infection was significantly more prevalent in patients with diabetes mellitus (DM) over 60 years of age than in non-DM subjects of a similar age (p = 0.004). In the DM group, Klebsiella pneumoniae was the most common aerobic pathogen and tended to involve more than two anatomical spaces (p < 0.0001). Seventeen out of 18 patients (94.4 per cent) displayed an elevated (> or = 7 per cent) glycosylated haemoglobin level. The DM group had a significantly higher complication rate, longer hospital stay and tracheotomy rate than the non-DM group. CONCLUSIONS: Diabetic DNI differs from non-diabetic DNI in several aspects and is associated with a higher morbidity. A greater than normal haemoglobin A1c level was commonly observed.
