Sjogren's Syndrome in patients with HTLV-I-associated myelopathy(HAM) :

目的：研究与干燥综合征相关的HTLV-I相关性脊髓病(HAM)患者的主要唾液腺的影像特征，并将这些特征与HAM阴性的干燥综合征患者进行比较。研究对象和方法。研究对象包括31例HAM患者(其中12例与干燥综合征相关)，15例HTLV-I阳性/HAM阴性的干燥综合征患者，以及41例HTLV-I阴性的干燥综合征患者。另外还对20例HAM阴性的单纯干燥综合征患者进行了研究。唾液腺的诊断性成像(唾液造影、磁共振成像和超声成像)。对患者进行唇腺活检、Schirmer试验、Saxon试验和血清学试验。结果。在12例干燥综合征HAM患者中，11例(92%)腮腺和颌下腺完全缺乏该病的异常影像特征，而唾液流率下降的程度与HAM阴性的干燥综合征患者相似。与HAM阴性干燥综合征患者相比，HAM干燥综合征患者唇腺的单个核细胞聚集程度明显降低。相反，所有HAM阴性的干燥综合征患者都表现出疾病的异常影像特征，唾液功能障碍的严重程度与影像表现有很好的相关性。这些结果表明，HAM患者的干燥综合征可能至少部分地通过一种与HAM阴性患者的典型干燥综合征不同的机制发生。

Objective.To characterize imaging features of the major salivary glands in patients with HTLV-I-associated myelopathy(HAM) who were associated with Sjogren's syndrome, and to compare these features with those in HAM-negative patients with Sjogren's syndrome. Subjects and Methods. The study propulation included 31 HAM patients(12 were associated with Sjogren's syndrome), 15 HTLV-I-seropositive/HAM-negative patients with Sjogren's syndrome, and 41 HTLV-I-seronegative patients with Sjogren's syndrome. Separate 20 HAM-negative patients with sicca syndrome only were also studied. Diagnostic imaging(sialography, MR imaging, and sonography) of the salivary glands. labial gland biopsy, Schirmer test, Saxon test and serological tests were performed on these patients. Results. The parotid and submandibular glands in 11(92%) of the 12 HAM patients with Sjogren's syndrome completely lacked the abnormal imaging features characteristic of the disease, while they displayed decreased salivary flow rates at levels similar to those in the HAM-negative patients with Sjogren's Syndrome. The labial glands from the HAM patients with Sjogren's syndrome exhibited significantly lower magnitudes of mononuclear cell aggregation compared with those in the HAM-negative patients with Sjogren's syndrome. In contrast, all HAM-negative patients with Sjogren's syndrome showed abnormal imaging features characteristic of the disease, and the severity in salivary dysfunction correlated well with the imaging findings.Conclusion. These results suggest that Sjogren's syndrome in HAM patients may at least in part occur via a distinctive mechanism from classical Sjogren's syndrome in HAM-negative patients.