关键词: 干燥综合征, 结核, 肺/诊断, 诊断,鉴别

Abstract: Objective  To explore the clinical features of TB complicated with primary Sjogren’s syndrome, and differentiate the interstitial lung disease caused by tuberculosis and primary Sjogren’s syndrome. Methods  A retrospective analysis of clinical data of 28 TB patients complicated with primary Sjogren’s syndrome in the 309 Hospital of People’s Liberation Army. Results  Among the 28 cases of TB patients, there were 2 males and 26 females. Twenty-one females were over 40 years old. The most common symptoms were throat dryness or coughing, dry eyes, dry mouth, fever. Six cases were diagnosed of primary Sjogren’s syndrome for the first time, and they were all administered autoantibody test and parotid gland X-ray enhanced angiography examination. Two cases had positive biopsies of labial gland. The remaining 22 cases had a history of Sjogren’s syndrome from a minimum of 1 year to maximum 14 years, with an average of （2.7±1.6）years. Ten cases established their diagnosis of TB by positive bacteriological evidence, 8 cases by histopathology, and 10 by clinical signs and symptoms. Among the 28 cases, 11 cases were classified as secondary pulmonary tuberculosis, 3 as hematogenous disseminated tuberculosis, 2 as tuberculous pleurisy, 2 as lymph node tuberculosis, 1 as secondary pulmonary tuberculosis complicated with endobronchial tuberculosis, 2 as secondary pulmonary tuberculosis complicated with lymph node tuberculosis, 2 as secondary pulmonary tuberculosis complicated with tuberculous pleuritis, 2 as secondary pulmonary tuberculosis complicated with tuberculous pericarditis, 2 as tuberculous serous cavity inflammation, 1 as secondary pulmonary tuberculosis complicated with endobronchial tuberculosis and accessories tuberculosis. All patients were given 2HRZE/4HR anti-TB treatment. So far, five cases are still on anti-TB treatment, the remaining 23 cases were all clinically cured of TB. All patients had not occurred serious adverse drug responses. Four cases of pulmonary tuberculosis were misdiagnosed as interstitial lung disease caused by primary Sjogren’s syndrome. Conclusion  Regarding the primary Sjogren’s syndrome complicated with TB, we should give special attention to the differentiation of the damage of the respiratory system caused by Primary Sjogren’s syndrome and by TB, reduce the occurrence of clinical misdiagnosis and missed diagnosis.

Key words: Sjogren&, rsquo, s syndrome, Tuberculosis, pulmonary/diagnosis, Diagnosis, differential