autoimmune disease and dysphagia

日本臨床免疫学会会誌に「特定疾患対策研究事業における強皮症の臨床調査個人票の疫学集計」 （坂内文男, 森満, 石川治, 遠藤秀治, 新海浤, 26(2) : 66-73, 2003）が掲載されている。
［Summary］We conducted an epidemiological study of systemic sclerosis in Japan using the records of patients who had been registered to receive public financial aid. A total of 10,956 patients were registered as having systemic sclerosis in 1999. We statistically analyzed the data on the patients, including sex, age, major symptoms, and laboratory findings. We also made contingency tables in order to evaluate the correlations of the data. Our study estimated that the male/female ratio was 1：7.3. The mean ages of male and female patients were 58.8 and 58.5 years old, respectively. The major symptoms were as follows：Raynaud's phenomenon 92.4%, skin sclerosis 94.7%, dyspnea 29.9%, and dysphagia 32.2%. With respect to specific antibodies, antinuclear antibody was present in 92.2%, antitopoisomerase I antibody in 27.5%, anticentromere antibody in 37.7%, and antiribonucleoprotein antibody in 19.9%. Making contingency tables, we could elucidate the association of antitopoisomerase I with lung fibrosis.
文献検索をすると、自己免疫疾患の嚥下障害では、重症筋無力症の症例報告が多い。少数例では、強皮症の嚥下障害も報告されている。実際文献上では、強皮症や皮膚筋炎患者では咽頭期嚥下障害に目が行きがちになるが、食道蠕動運動低下による食道期障害にも眼を向ける必要がある。そのためにも、VFが実施できる環境であれば、依頼し食道期まで含めた観察が重要になると考える。