{"created":"2023-05-15T11:21:21.788292+00:00","id":33,"links":{},"metadata":{"_buckets":{"deposit":"a05be507-2581-442d-a91a-6b361510c825"},"_deposit":{"created_by":1,"id":"33","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"33"},"status":"published"},"_oai":{"id":"oai:showa.repo.nii.ac.jp:00000033","sets":["1:6:7:9"]},"author_link":["111","109","107","104","108","113","105","110","106","112"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018-06","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"3","bibliographicPageEnd":"281","bibliographicPageStart":"275","bibliographicVolumeNumber":"78","bibliographic_titles":[{"bibliographic_title":"昭和学士会雑誌"}]}]},"item_10002_description_6":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"原発性シェーグレン症候群（Sj?gren’s syndrome, SS）は慢性唾液腺炎と乾燥性角膜炎を主徴とする自己免疫疾患である．小児膠原病疫学調査において若年性特発性関節炎，全身性エリテマトーデスに次ぐ高頻度な疾患であることが明らかにされた．小児では目や口の乾燥を呈する腺症状ではなく，非特異的な症状で受診する例が多い．今回，日常生活に支障をきたすほどの全身倦怠感や発熱の反復などの症状を認めながら，長期間にわたり起立性調節障害（Orthostatic Dysregulation, OD）と診断されていたSSの1例を経験したので報告する．症例は14歳女児．12歳時にめまいと一時的な両下肢の筋力低下を自覚したのを契機にODと診断された．その後も頻回な倦怠感を訴え，複数の診療科・施設でODと診断されていた．14歳時に発熱，嘔吐，腹痛，下腿紫斑を主訴に前医に入院し，アレルギー性紫斑病の疑いでプレドニゾロン（PSL）の投与を開始された．しかし，症状改善せず，多様な所見が加わったため当科に紹介となった．抗核抗体，抗SS-A/Ro抗体，抗SS-B/La抗体が陽性，ガム試験と口唇小唾液腺生検がSSの診断基準を満たし，原発性SSと診断した．PSLは漸減中止しNSAIDsの内服を開始したが，低血圧および全身倦怠感が増悪した．その後，昇圧剤やPSLの内服を再開するも症状のコントロールが困難だったため，免疫抑制剤を投与した．現在はPSL，シクロスポリン，昇圧剤の内服を併用し加療中である．倦怠感や原因不明の発熱や皮疹などの症状を繰り返す症例では，腺症状がなくともSSの可能性を考慮し，精査する必要性があると考えられた．","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"昭和大学学士会"}]},"item_10002_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"10.14930/jshowaunivsoc.78.275","subitem_relation_type_select":"DOI"}}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2187-719X","subitem_source_identifier_type":"ISSN"}]},"item_10002_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"岡本, 奈央子"}],"nameIdentifiers":[{"nameIdentifier":"104","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"岡本, 義久"}],"nameIdentifiers":[{"nameIdentifier":"105","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"石川, 琢也"}],"nameIdentifiers":[{"nameIdentifier":"106","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"大貫, 裕太"}],"nameIdentifiers":[{"nameIdentifier":"107","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"小川, 玲"}],"nameIdentifiers":[{"nameIdentifier":"108","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"児玉, 雅彦"}],"nameIdentifiers":[{"nameIdentifier":"109","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"渡邊, 常樹"}],"nameIdentifiers":[{"nameIdentifier":"110","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"西岡, 貴弘"}],"nameIdentifiers":[{"nameIdentifier":"111","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"池田, 裕一"}],"nameIdentifiers":[{"nameIdentifier":"112","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"磯山, 恵一"}],"nameIdentifiers":[{"nameIdentifier":"113","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-07-26"}],"displaytype":"detail","filename":"78_275.pdf","filesize":[{"value":"524.1 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"78_275.pdf","url":"https://showa.repo.nii.ac.jp/record/33/files/78_275.pdf"},"version_id":"ff85e1b2-bc78-49f4-b11a-ae41d160133a"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"複数の医療施設で起立性調節障害と診断されていたシェーグレン症候群の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"複数の医療施設で起立性調節障害と診断されていたシェーグレン症候群の1例"}]},"item_type_id":"10002","owner":"1","path":["9"],"pubdate":{"attribute_name":"公開日","attribute_value":"2018-11-08"},"publish_date":"2018-11-08","publish_status":"0","recid":"33","relation_version_is_last":true,"title":["複数の医療施設で起立性調節障害と診断されていたシェーグレン症候群の1例"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2023-05-15T13:13:44.716990+00:00"}