Læknaneminn - 01.04.1997, Síða 12

Björn Guðbjörnsson
sjúkdómsmynd hafi einn ábyrgan lækni með góða
þekkingu á sjúkdómsástandinu og sjúklingnum.
SJÚKDÓMAR ER LÍKJAST
HEILKENNUM SJÖGRENS
Margir bandvefssjúkdómar líkjast pSS og er þar fyrst
að nefna rauða úlfa og blandaðan bandvefssjúkdóm
(MCTD). Sjúklingar með pSS hafa oft jákvæð gigtar-
próf og vegna liðeinkenna sinna getur sjúkdómurinn á
byrjunarstigi líkst iktsýki. Eins og fyrr segir einkennist
pSS af vöðvaverkjum og þreytu, auk sicca einkenn-
anna, þetta getur misleitt hugann að fjölvefjagigt. Aug-
ljóst er að mismunagreining er mikilvæg, svo að sjúkl-
ingar með pSS fái réttar upplýsingar um sjúkdóm sinn,
meðferð og eftirlit (ath. hættu á eitlaæxlum).
Aðrir sjúkdómar, t.d. sarklíki, frum- eða bólgu-
mýildi, lifrarbólga, blóðfitusjúkdómar og Hodgkin’s
sjúkdómur geta einnig líkst pSS. Á sama hátt getur
græðlings vs. hýsils viðbragð og upphafsstig alnæmis
verið sláandi líkt pSS. Margt þarf því að hafa í huga,
áður en sjúkdómsgreiningin primary Sjögren’s syn-
drome er staðfest.
SAMANTEKT
Hér að framan hefur verið gerð grein fyrir sögu heil-
kenna Sjögrens. Ahersla hefur verið lögð á að vandi
Sjögrens sjúklinganna er ekki eingöngu sicca einkenn-
in, heldur er sjúkdómsmyndin margbreytileg frá einu
sjúkratilfelli til annars, sem gerir sjúkdómsgreiningu oft
á tíðurn erfiða.
ÞAKKIR
Höfundur þakkar próf. Rolf Manthorpe og félögum íyrir leyfi birtingar
mynda (að frátalinni mynd nr. 6). Einnig þakkar höfundur Maríu S. As-
grímsdóttur fýrir góða ritarahjálp.
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LÆKNANEMINN
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1. tbl. 1997, 50. árg.