쇼그렌증후군(Sjögren’s syndrome): 치료

치료 목적

안구 건조
- 눈물 보충위해 안약 이용 : Tearisol, Liquifilm, 0.5% methylcellulose, Hypo Tears 등
- 각막궤양 : 안대, 붕산연고
- 눈물과 침 분비를 감소시키는 약제 피한다 : 이뇨제, 항고혈압제, 항콜린작용약, 항우울제
구강 건조
- 충분한 수분 섭취
- 분비 촉진 : pilocarpine 또는 cevimeline 경구 투여
질 건조
- 프로피온산 겔(propionic acid) 사용
관절 증상 : Hydroxychloroquine
콩팥세뇨관산증 : sodium bicarbonate 경구투여
전신적인 혈관염 : glucocorticoid, 혹은 immunosuppressive agents
고등급 림프종 : 전통적 CHOP 요법과 항CD20 단클론항체 병합치료

쇼그렌증후군의 치료

Glandular manifestation
Dry eye	Avoid	Smoking areas, windy, low humidity environment, drugs with anticholinergic action, diuretics
	Lubrication	Artificial tears without preservatives, bicarbonate-buffered elec-trolyte solutions
	Local stimulation	Cyclic adenosine mono-phosphate, cyclosporine 2% olive solu-tion
	Systemic stimulation	Pilocarpine (5 mg twice daily orally); convimetine (30 mg twice daily orally)
	Severe dry eyes	Nasolacrimal duct occlusion (temporary or permanent); soft con-tact lenses; corneal transplantation
Dry mouth	Oral hygiene after each meal Topical application of fluoride
	Lubrication	Water
	Local stimulation	Sugar-free, flavored lozenges or gum
	Systemic stimulation	As for dry eyes
	Oral candidiasis	Topical nystatin or clotrimazole lozenges
Parotid gland enlargement	Apply	Local wet heat
	Treat superinfection	Antibiotics, analgesics
	Persistent, hard	Rule out lymphoma
Extraglandular manifestation
Arthritis	Hydroxychloroquine (200~400 mg/d) or Methotrexate (0.2-0.3 mg/kg body weight weekly) plus Prednisolone (10 mg daily orally)
Raynaud’s phenomenon	Cold protection: gloves Nifedipine (10 mg twice daily)
Renal tubular acidosis	Bicarbonate replacement
Vasculitis	Standard treatment
lymphoma	CHOP + anti-CD 20

참고자료