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Kazuo Tsubota, Hiromi Fujita, Kensei Tsuzaka, Tsutomu Takeuchi; Mikulicz’s Disease and Sjögren’s Syndrome. Invest. Ophthalmol. Vis. Sci. 2000;41(7):1666-1673.
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purpose. To characterize lacrimal gland function and lymphocyte infiltration in
patients with Mikulicz’s disease (MD) and Sjögren’s syndrome
methods. Four patients with MD and 5 with SS were recruited, on whom
were performed Schirmer test I (Schirmer test without anesthesia),
Schirmer test with nasal stimulation, and vital staining of the ocular
surface. The lacrimal gland was then biopsied and the tissues stained
with CD3, CD4, CD8, B220, APO2.7, Fas, and Fas ligand (Fas-L)
results. Although regular Schirmer test results in the MD group were less than
10 mm, those with nasal stimulation, 38.1 ± 3.4 mm, were
significantly greater than the SS group. There were minimal ocular
surface changes in MD. Morphologic staining with hematoxylin and eosin
was identical in both groups, but the acinar cells were stained with
APO2.7 only in the SS group. There was strong Fas and Fas-L staining in
SS patients but not in those with MD.
conclusions. Lacrimal gland acinar cells in those with MD maintained their function
and were not programmed for cell death. The sicca syndrome was not
observed in MD patients. Although the pathology is similar for MD and
SS, the difference in acinar cell apoptosis and function can explain
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