diflucan mechanism of action

Age at diagnosis

Q:  I have a positive ANA of 1:640, SSA/SSB negative. Other AI lab tests all
negative. My lip biopsy pathology reads as: Mild chronc inflammatory infiltrate
noted including one lymphocyte focus consisting of >50 lymphocytes. I have had
dizziness and unilateral arthritic flares in my hands. I have not seen a
rheumatologist regarding these findings yet. The PCP advises these findings as
suggestive of Sjogren's. I am hoping you can provide your opinion.

Also, I have only had symptoms of dry eyes and mouth for 2 years, mostly mouth.
I have salivary gland stones in the submandibular which are now located in the
duct canal, about 2cm worth.  Given that I have only had symptoms for 2 years
and the arthritis symptoms only very recently, would it suffice to say that mild
chronic inflammation would be normal at this stage? Also, give that symptoms are
only 2 years in the process, can I expect further developments of symptoms and
more severity of the ones I currently have?  I ask because I did consult a rheum
MD prior to all of these studies and he suggested that at my age (50) that what
I have now would be as bad as it ever gets due to the age of onset.

A:  Although the US-European Consensus Criteria for diagnosing Sjogrens are designed for defining groups for Research and should not be used soley for diagnosing pts in clinical practice, you would even meet the criteria for a diagnosis of Sjs and would be considered for a research trial. Whether you have primary or secondary Sjs depends on a full evaluation to exclude other autoimmune disorders. The US-EU Criteria use a Focus Score (lymphocyte group) of Greater than or Equal to ONE.

Chronic inflammation is never normal-the question is what is causing it.

Age alone does not absolutely define prognosis. Although in general if the process starts later it has less time to do irreversable damage. A reminder, most AI disorders/activity fluctuates-therefore the symptoms can remit and flare.

Age alone does not absolutely define prognosis. Although in general if the process starts later it has less time to do irreversable damage. A reminder, most AI disorders/activity fluctuates-therefore the symptoms can remit and flare.

dr c

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