Primary Sjögren’s syndrome with minimal change disease—A case report

Glomerular involvement in patients with primary Sjögren’s syndrome (pSS) has rarely been reported. Among them, membranoproliferative glomerulonephritis and membranous nephropathy are the more common types. We report a middle-aged female presenting concurrently with nephrotic syndrome and microscopic hematuria, and her pSS was diagnosed by positive anti-Ro (SSA)/anti-La (SSB) autoantibodies, dry mouth, severely diffuse impaired function of both bilateral parotid and submandibular glands, and a positive Schirmer test. Renal pathology revealed minimal change disease and thin basement membrane nephropathy. The patient’s nephrotic syndrome resolved after treatment with corticosteroids. To our knowledge, this is the first report of minimal change disease in a patient with pSS.

摘要過去很少有關於原發性休葛蘭症候群合併腎絲球疾病的報告。其中，又以膜性增殖性腎絲球腎炎及膜狀腎絲球腎炎比例最多。本報告報導一位中年女性因雙下肢水腫而就醫，經診斷為腎病症候群，又因其anti-Ro (SSA)/anti-La (SSB) 自體免疫抗體呈陽性反應，嘴巴乾燥，雙側耳下腺及頷下腺呈彌漫性功能受損，且經Schirmer test診斷為乾眼症，其他檢驗結果顯示無其他結締組織疾病。因此，診斷此病人罹患原發性休葛蘭症候群。腎臟切片檢查顯示其腎臟有微小變化症腎炎及薄基底膜病變。此病人經類固醇治療後，腎病症候群之症狀已大有改善。這是首例原發性休葛蘭症候群合併微小變化症腎炎的報告。