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The frequency of sicca symptoms and S jögren's syndrome in patients with systemic sclerosis
Author(s) -
Kobak Senol,
Oksel Fahrettin,
Aksu Kenan,
Kabasakal Yasemin
Publication year - 2013
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/j.1756-185x.2012.01810.x
Subject(s) - medicine , sicca syndrome , xerophthalmia , gastroenterology , scleroderma (fungus) , autoantibody , rheumatoid arthritis , serology , pathological , rheumatoid factor , biopsy , dermatology , antibody , pathology , disease , immunology , vitamin a deficiency , retinol , vitamin , inoculation
Objective The objectives are to detect the frequency of sicca symptoms and S jögren's syndrome ( SS ) in patients with systemic sclerosis ( SS c) based on the diagnostic criteria of the A merican– E uropean C onsensus G roup ( AECG ) and to evaluate demographic, clinical and serologic characteristics. Patients and method One hundred and eighteen SS c patients referred to our hospital were included in this study. All SS c patients were questioned with respect to sicca symptoms. Levels of rheumatoid factor ( RF ), anti‐nuclear antibodies ( ANA ), anti‐ R o and anti‐ L a antibodies were measured; non‐stimulated saliva amounts were recorded and S chirmer test and break‐up time were applied to all patients. Minor salivary gland biopsy samples were obtained from those patients giving ≥ 3 positive answers to sicca symptom questions, patients with positive xerostomia/xerophthalmia test results, and patients with at least one antibody being positive. Patients presenting with grade 3 and/or grade 4 sialoadenitis based on Chisholm criteria were considered pathological. Results Sicca symptoms were present in 84 of 118 patients with SS c (71.2%). Minor salivary gland biopsy samples were obtained from 74 patients. Grade 3 and/or grade 4 sialoadenitis was detected in 40 (33.9%) patients and they were diagnosed with SS . Compared to patients diagnosed with SS c alone, systemic sclerosis patients diagnosed with SS had lower pulmonary hypertension and less diffuse lung involvement. Statistically significant difference was detected in terms of sclerodactylia and telangiectasia between SS c– SS and SS c patient groups ( P = 0.045 and P = 0.011, respectively). Serological assessments revealed that in the SS c– SS group, 13 patients were anti‐ R o antibody positive, six were anti‐La antibody positive and 37 were anti‐topoisomerase 1 antibody positive. RF , ANA and anti‐centromere antibody levels were higher in the SS c– SS group. Conclusion In the present study, highly frequent sicca symptoms and S jögren's syndrome based on AECG criteria were noted in patients with systemic sclerosis. The SS c– SS patient group had less severe clinical course and lung involvement.