[A case of @entity244 with marked @entity1283 , atypical onset and XXXX ].

@entity1 @entity6016 @entity6540 @entity706 @entity1283 @entity7491 @entity4754 @entity936 @entity244 @entity8352 @entity288
Since July, 1999, a 66 year-old @entity1 had been complaining of dry cough. He noticed submandibular swelling, @entity1283 and @entity936 . Keratoconjuctivitis sicca was detected by an ophthalmologist. @entity244 was diagnosed based on microscopic findings of a labial salivary gland biopsy although anti- @entity6540 and anti- @entity6016 antibodies were negative. @entity4754 (IgG 3916 mg/dl) and @entity7491 were pointed out. Swelling of mediastinal and abdominal lymph nodes was detected together with enlargement of salivary and lacrimal glands. We suspected the existence of @entity706 , but a biopsy of lacrimal glands showed only lymphocytic and plasma cell infiltration and immunohistochemical analysis denied monoclonality of lymphoid line. An administration of @entity288 caused rapid diminution in size of lacrimal and submandibular glands and lymph nodes. Clinical symptoms were also improved, but IgA-M proteinemia remains. The characteristics of our case were enlargement of lacrimal glands, the negativity of anti @entity6540 and @entity6016 antibodies, atypical onset and @entity8352 . We discussed about these characteristics of @entity244 in our case.
