Chapter 297 Sjögren's Syndrome
"Doctor Wei, can you tell me why I got this disease and how it is related to my indigestion?" asked the patient.
That's what she wanted to know too. Why?
To ordinary people, these two things have nothing to do with each other, but why was this disease diagnosed?
In fact, it can be understood that the body's secretions are reduced, resulting in this series of reactions.
Such effects include dry skin, reduced secretion in the eyes, nose, trachea, digestive tract, vagina, etc.
It’s just that some people may have more serious problems in one area, like this patient’s digestive tract is more affected.
Since she wanted to know, Wei Ping would tell her and explain the reason to the interns.
"Okay, what I'm going to tell you next is why it's related to your indigestion."
The woman didn't say anything else, she just listened to Wei Ping.
“This disease affects seven aspects of a person’s life.
First, the skin manifestations include a purpuric rash, most commonly on the lower extremities. These rash appear as rice-sized, well-defined, red papules that resist pressure and appear in batches. Each batch lasts about 10 days and resolves on its own, leaving behind brown pigmentation. You have almost none of this; you only experience dryness.
It also affects the joints. Joint pain is common, but usually there is no damage to the joint structure. You don't have it either, so you are lucky. If the joints were affected, it would cause a lot of inconvenience.
About half of patients experience renal damage, primarily affecting the distal renal tubules, which may result in renal tubular acidosis. A small number of patients develop more pronounced glomerular damage, clinically manifested by massive proteinuria, hypoalbuminemia, and even renal insufficiency.
Most patients experience no respiratory symptoms. Mildly affected individuals experience a dry cough, while severe cases experience shortness of breath. Interstitial lesions are the primary pathology of the lungs, and a small percentage of patients develop pulmonary hypertension. Patients with pulmonary fibrosis and severe pulmonary hypertension have a poor prognosis.
As for the digestive system, non-specific symptoms such as atrophic gastritis, decreased gastric acid, and indigestion may occur, and patients may have liver damage. Madam, you are just that!
There are also some cases of damage to the nervous system, with peripheral nerve damage being the most common.
Finally, the blood system can be affected, with decreased white blood cell counts or thrombocytopenia. Severe thrombocytopenia can lead to bleeding. The incidence of lymphoma in this disease is much higher than in the normal population.
When the patient heard this, he realized that this was the manifestation of the disease.
Those doctors couldn't find out what was wrong with her, so they probably didn't try hard enough.
She even went to see a gynecologist.
But it didn't solve it either.
Therefore, sometimes the symptoms that appear over a period of time may point to one disease rather than several separate diseases.
This requires comprehensive consideration, and of course patients must truthfully disclose their situation.
Otherwise, even if you miss one thing, it may affect the judgment of the result. For some diseases, if you make a wrong diagnosis, the impact will be huge, just like the patient at noon. If it weren't for Wei Ping, the diagnosis might have been delayed for a while, and by then, everything would be too late.
After Wei Ping finished speaking, he asked, "Have you all written it down?"
"I've made a note of it. This disease is not very common. We need to consider all aspects comprehensively to finally come up with a direction. It would be best to assist with testing to finally confirm the diagnosis." Xiao Xia said.
When the woman heard Xiao Xia say this, she asked again, "Should I get another checkup to confirm the diagnosis?"
In response, Wei Ping said, "Okay, I'll prescribe you a set of rheumatology and immune antibody tests, but the results won't be out until tomorrow. I'll also test for anti-SSA antibodies, anti-SSB antibodies, and a saliva flow test! Let's do all of these!"
Since she did it, let's do it, let her feel at ease. She had been worried before whether it was stomach cancer, but after the examination, she was relieved.
If it is really this disease, it might be better.
After all, this disease doesn't seem to be very serious.
"Okay, thank you, Dr. Wei." the woman said at this time.
"You're welcome. This is what I should do. We also hope that you are well. Of course, I don't want you to spend too much money, so I didn't prescribe a checkup for you!"
The APP prompts that the disease is there and there is no point in checking it again, but if the patient wants to check, then he will check it. He won’t waste his breath.
"Brother Wei, how do you treat this disease?"
the intern asked.
"Because it's an immune-related disease, you can use glucocorticoids, immunosuppressants, etc. You also need to drink enough water and keep your mouth clean."
"How long will it take to treat?" the woman asked again.
"As for two months or more, it is a long process. It is not like a common cold that will be cured in seven or eight days." Wei Ping added.
"Ma'am, you are lucky your liver isn't affected!"
"Okay, thank you, Doctor Wei!"
The woman said very moved.
"Also, I'll prescribe some medicine for you. You can take it first. It may relieve your symptoms today. Come back to me when the results come out!"
"good!"
Wei Ping then prescribed medicine for the patient.
Finally, he said, "This disease requires extra care in daily life. In addition to keeping your mouth clean, you have dry skin, so I suggest you get a humidifier to increase the humidity in the room. Use E-emulsion to moisturize your skin and mucous membranes. Don't bathe too frequently, about twice a week, and avoid using irritating shower gels. For the problem of dry eyes, I prescribed artificial tear drops! Also, be sure to stay away from the sun, and it's best not to sunbathe. Don't wear makeup or dye your hair until you recover. As for your diet, avoid spicy food, tobacco, and alcohol..."
Wei Ping explained it in great detail.
"I understand. I've written it all down."
The woman had been recording on her phone. After all, Wei Ping had said so much that she couldn't remember it all at once, so she recorded it and then transcribed it into text.
"Okay, the medicine is ready. Go settle the bill and then get the medicine."
"OK!"
The patient then left.
After she left.
Everyone started discussing.
"I never thought that Sjögren's syndrome could affect the digestive system."
“That’s what immune diseases are like.”
"If I were to diagnose it, I might just prescribe some digestive medicine and be done with it."
"Me too! Senior Brother Wei also diagnosed indigestion just now."
"That was just a symptom. The root cause wasn't found. Didn't Senior Brother Wei find it later?"
"After three years, they haven't cured a disease yet. How did the doctors in the past treat it? They're not even as good as our senior brother!"
"I think it's probably because she keeps looking for different doctors to treat her."
"Yeah, sometimes if you trust it, you still have to find a doctor to treat it."
…
Wei Ping did not participate in the discussion.
He looked outside.
"Call your number!"
"Next!"
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