Differences in the clinical feature of Sjögren syndrome in the presence and absence of rheumatoid arthritis

Abstract

In our study, we investigated the clinical features of sicca syndrome in the presence and absence of rheumatoid arthritis. Twenty patients with sicca syndrome alone and 22 patients with sicca syndrome accompanied by rheumatoid arthritis were examined. The average onset age of the sicca syndrome alone is 12 years younger than the syndrome associated with rheumatoid arthritis. Moreover, rheumatoid arthritis tended to antecede the clinical onset of the sicca syndrome in the latter group. Relevant to the clinical investigative data, frequent lower values of CH 50 and positive reactions to the anti-nuclear antibody were noted in the sicca syndrome alone group. In this group, a lowering of cell-mediated immunity and a decrease in lysozyme density in lacrimal fluid were also noted. Relevant to the clinical manifestation, a high frequency of recurrence of parotitis, purpura and lymphadenopathy was also noted. Related to the joint findings, 45% of the patients with sicca syndrome alone disclosed clinical evidence for arthritis, however, no significant radiographic findings were observed. It is clear that there were distinct differences in clinical figures in both groups, while continuity of the clinical figures between them was also confirmed. When we take the known pathological and molecular genetic findings into consideration, it may be assumed that the differences in the clinical figures between these two entities could result from the difference of the causative mechanism of the conditions. Furthermore, we may safely say that the sicca syndrome alone may reflect the essential pathophysiologic figure of this particular syndrome.