(I) (a) Case I; A housewife (42 years of age). From 34 years of age, she developed symptoms: dryness of oral and nasopharyngeal cavity and lips, reduced perspiration, fever up to around 40°C at 3 times, rhagades of tongue, angular stomatitis, recurrent dental caries, strange sensation on bilateral lower palpebrae, photophobia, and malaise.
Laboratory Findings: There were observed normocytic anemia, rouleaux formation of erythrocytes, bone marrow hypoplasia with as light increase of plasma cell, remarkable increase of erythrocyte sedimentation rate, and extremely high values of the serum colloidal reactions. γ-globulin was 41% and increment of ‘γ-G’ was remarkable.
Gastric anacidity and severe atrophic gastritis were observed by X-ray, gastrocamera and gastric biopsy, which revealed diffuse round-cell infiltration.
Liver biopsy showed no remarkable change in parenchymal cells but a slight infiltration of polynucleated leukocytes and round-cell in Glisson's capsule.
At the same time focal round-cell infiltration of moderate degree in the interstitial tissue was found by renal biopsy.
(b) Cace II; A housewife (42 years of age). From 35 years of age, she gradually started to complain blurred vision and oral dryness.
Laboratory Findings.: A slight increase of plasma cell in bone marrow, remarkable erythrocyte sedimentation rate, positive serum colloidal reactions, increament of γ-globlin and gastric anacidity were conspicuous findings. According to histological figure of biopsy specimen, interstitial nephritis and atrophic gastritis of slight degree was considered.
The above-mentioned two cases were classified to group E of the 5 groups by Bunim.
(II) 75 cases cited in literatures were described.
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