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

目标。研究htlv - 1相关性脊髓病（HAM）合并干燥综合征患者大唾液腺的影像学特征，并与HAM阴性合并干燥综合征患者的影像学特征进行比较。研究对象和方法。研究人群包括31例HAM患者（12例与干燥综合征相关），15例htlv - 1血清阳性/HAM-阴性的干燥综合征患者，41例htlv - 1血清阴性的干燥综合征患者。单独研究了20例ham阴性的仅伴有干燥综合征的患者。唾液腺的诊断成像（唾液造影、磁共振成像和超声）。对这些患者进行唇腺活检、Schirmer试验、Saxon试验和血清学试验。结果。在12例伴有干燥综合征的HAM患者中，11例（92%）腮腺和下颌下腺完全没有该疾病的异常影像学特征，而他们的唾液流率下降的水平与HAM阴性的伴有干燥综合征的患者相似。与HAM阴性的干燥综合征患者的唇腺相比，HAM阴性的干燥综合征患者的唇腺单核细胞聚集量明显降低。相反，ham阴性的干燥综合征患者均表现出异常的影像学特征，且唾液功能障碍的严重程度与影像学表现有良好的相关性。这些结果表明，HAM患者的干燥综合征可能至少部分通过与HAM阴性患者的经典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.