原發性Sjogren氏症候群病患具單株性A型球蛋白病變

IgA Monoclonal Gammopathy in A Patient with Primary Sjögren's syndrome

一名六十八歲女性病患因經常性的咳嗽及發熱至本院求診。過去曾罹患肺結核、全身對稱性關節痛及晨間僵硬、皮膚蝴蝶疹及支氣管擴張症。病程及臨床表現不符合全身性紅斑性狼瘡或類風濕性關節炎等原發性疾病的診斷。病患有數年之乾眼及口乾之表現，而且血清抗SS-A及抗SS-B抗體為陽性。血清免疫球蛋白電泳顯示kappa型單株性A型球蛋白增多。

We report a 66-year-old female case that had old tuberculosis, bronchiectasis, symmetric arthralgia, joint morning stiffness, skin malar rash, dry eyes and dry mouth. Immunoelectrophoresis revealed kappa type monoclonal immunoglobin A (IgA). Positive anti-SS-A/SS-B antibody (Ab) and low antinuclear and antiDNA Ab titer were detected. It suggested the patient suffered primary Sjögren's syndrome with IgA monoclonal gammopathy.