Sjogren's syndrome

18 september 2018
Савельева Олеся Григорьевна
district physicians, терапевт дежурный
Patient K., 56 years old.

The patient has been observed in the clinic since 2009.

The main diagnosis is rheumatoid arthritis, polyarthritis, seropositive, act 3, stage 3, FN 2.

Characteristics of the articular syndrome:

· Morning stiffness for more than 1 hour;

Pain in symmetrical wrist, metacarpophalangeal, proximal interphalangeal joints of the hands, knee, ankle, metacarpophalangeal joints.

Medical history.

Sick since 1979

· The diagnosis was established and confirmed at the Research Institute of Rheumatology in the same year.

· In 2008, was observed at the Charite clinic in Berlin with a diagnosis of seropositive rheumatoid arthritis with secondary Sjogren's syndrome.

· In 2009, she was seen at the Genolier clinic in Switzerland. A comprehensive examination and treatment was carried out, which confirmed the presence of rheumatoid arthritis with a mild clinical Sjogren's syndrome.

Ongoing therapy

Life history.

· Lives and works in Moscow.

· Since 1977, suffers from autoimmune thyroiditis with subcompensated hypothyroidism.

· 2004 - cholecitectomy.

· Suffers from gastric ulcer and duodenal ulcer, chronic duodenitis.

· Gynecological history: B2 P1 A1.

Menopause since 1986

· 2008 - bilateral pneumonia.

Since 2009, Medicina has been observed.

· July 2009 applied to JSC "Medicine" in connection with pain in the left ankle joint - revealed aseptic necrosis of the head of the scaphoid, synovitis of the left ankle joint.

· Consultation with a rheumatologist. Intra-articular and oral treatment with prednisolone was recommended during therapy with Humira with improvement in the condition.

· November 2009 - was admitted to the hospital with a hypertensive crisis.


· The condition is satisfactory, t - 36.6;

· Skin of normal color.

· Dry skin, mucous membranes and conjunctiva.

· Injection of blood vessels of the sclera.

· Respiratory system - no pathology.

· Cardiovascular system - no pathology.

· Digestive system - no pathology.

St.localis :

· Defiguration of 2-4 metacarpophalangeal joints;

· Ulnar deviation;

· Deformation of the fingers like a "swan neck";

· Defiguration of the left ankle joint.


The head of the clinic drew attention to the prevailing place in the clinical picture of Sjogren's syndrome with a relatively low RA activity.

An immunological blood test is recommended for laboratory determination of the degree of activity of Sjogren's syndrome.

Immunoassay data:

·         SS-A/Ro >200 U / ml (norm: 0.0-25.0);

·         SS-B/La >200 U / ml (norm: 0.0-25.0).

Repeated consultation.

Conclusion: Sjogren's syndrome is the leading one in the clinical picture of the patient's disease.

Specific therapy was prescribed.

Dynamic surveillance.

Against the background of the prescribed therapy, the patient notes an improvement in her condition.