Abstract
Human serum amylase is mainly derived from the pancreas and salivary glands. The level of serum salivary amylase has been shown to be helpful in the diagnosis of sialadenitis. Serum pancreatic and salivary amylase activities in 32 Sjögren’s syndrome (SS) patients were examined to determine whether the rate of pancreatic (AAP) and salivary isoamylase (AAS) secretion levels were useful to determine the grade of disease state in SS. The level of Xerostomia and serum AAS were significantly correlated (p＜0.05) in the 32 SS patients.
An early stage 34 year-old female SS patient showed markedly high AAS. On the other hand, progressive stage 61 year-old SS patient displayed the reverse phenomenon in serum AAP and AAS levels, in that AAP was higher than the AAS level. An end-stage 77 year-old female SS patient showed a markedly low serum AAS level. These results suggested that the AAS level will increase at the early stage and reverse phenomenon, AAS becoming lower than AAP, will occur in the moderate stage and AAS level will markedly decrease in the end stage. We tried making one of a treatment guideline for grand symptoms related to the rate of serum isoamylase level. The SS patients in the early-stage, high AAS period, glucocorticoid or immunosuppressive therapy are indicated. Further in the SJS patients in the moderate-stage, reversing period of the level of AAS and AAP, medicine acting as salivary stimulant was indicated. Finally, in the period of AAS level becoming markedly low, medicine aiding the salivary fluid indicated.
We discussed that investigating the serum AA is useful for deciding suitable medication for gland symptoms in SS.
