Authors: Troels Ring Maria Kallenbach Jeppe Prætorius Søren Nielsen Birgitte Melgaard
Publish Date: 2005/11/08
Volume: 25, Issue: 6, Pages: 891-894
Abstract
We report the course of a 55yearold woman the first patient with primary Sjögrens syndrome and distal renal tubular acidosis but without lymphoma to be treated with Bcell depletion using Rituximab Rapidly after Bcell depletion remarkable improvement in xerostomia occurred while serological findings and tubular acidosis have been unchanged In labial salivary gland biopsy lymphocyte infiltration and particularly CD20positive cells decreased strikingly Aquaporin 1 AQP1 expression in myoepithelial cells was very low before treatment and increased noticeably Apical AQP5 in acinus cells likewise increased following Rituximab In contrast basolateral NKCC1 was expressed at unchanged intensity before and following Rituximab The improvement has been sustained and still is most gratifying 10 months after treatment Bcell depletion may be effective treatment in Sjögrens syndrome Likewise it may now be possible to separate the immunologic phenomena in Sjögrens syndrome from the consequences of prolonged hyposalivation when studying the pathophysiology of xerostomia
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