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本文报道1例腮腺肿大、口眼干燥的64岁女性患者,经涎腺造影与活组织检查证实为 Sj(?)gren 综合征(简称 SS)。体检时发现肝脏肿大伴轻度压痛,实验室检查发现白蛋白偏低、γ球蛋白升高;GPT 正常而 GOT 轻度升高;乳酸脱氢酶(LDH)、硷性磷酸酶(AKP)与γ-谷氨酰胺转肽酶(γ-GT)均显著升高;类风湿因子乳胶试验、凝集试验与抗核因子均阳性;HBsAK 阴性.肝穿刺活检显示汇管区有明显的慢性圆形细胞浸润与纤维化,然并无慢性活动性肝炎,肝硬化以及中毒性或郁胆性病变。单纯 SS 引起肝损害的报道很少,由于约半数患者合并类风湿性关节炎或其他结缔组织病,并可检出器官特异性抗体,本病被认为是自身免疫性疾病。其临床表现可累及多组织器官,但很少注意其伴有的特殊肝脏病变。
This article reports a case of 64-year-old female with parotid gland enlargement and dry mouth. Sj? Gren syndrome (SS) was confirmed by salivary gland angiography and biopsy. Liver enlargement accompanied by mild tenderness was found on physical examination. Low albumin and γ-globulin were found in laboratory tests. Normal GPT and mild GOT were elevated. Lactate dehydrogenase (LDH), alkaline phosphatase (AKP) and γ-glutamyl transpeptidase (γ-GT) were significantly increased; rheumatoid factor latex test, agglutination test and anti-nuclear factor were positive; HBsAK negative. Liver biopsy showed a significant portal area of chronic circular cell infiltration And fibrosis, but no chronic active hepatitis, cirrhosis and toxic or chlorotic lesions. Slight SS damage caused by the liver is rarely reported, as about half of patients with rheumatoid arthritis or other connective tissue disease, and can detect organ-specific antibodies, the disease is considered to be autoimmune diseases. Its clinical manifestations can affect multiple tissues and organs, but seldom pay attention to its accompanying special liver disease.