Abstract: Dry eyes and mouth syndrome-a subgroup of patients

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Rheumatology (Oxford) 2002 Apr;41(4):416-22

Price EJ, Venables PJ.

Department of Rheumatology, Princess Margaret

Hospital, Okus Road, Swindon SN1 4JU and. Kennedy

Institute of Rheumatology Division, Imperial College,

1 Aspenlea Road, London W6 8LH, UK.

PMID: 11961172

OBJECTIVE: To evaluate the characteristics of patients presenting with symptoms suggestive of Sjogren’s syndrome (SS) but failing to satisfy diagnostic criteria.

METHODS: Clinical, serological and histological data

were collected on 34 patients presenting with dry eyes

and/or mouth who did not satisfy the Vitali criteria

for the diagnosis of SS. They were compared with 136

patients with primary SS, 38 patients with secondary

SS, and 13 patients without SS. Questionnaires on

symptoms from each group were compared with 43 healthy controls.

RESULTS: The 34 patients who did not satisfy the

diagnostic criteria for SS or any other connective

tissue disease were designated dry eyes and mouth

syndrome (DEMS). Their demography including age was

similar to that of a primary SS group and there was no

more atrophy seen on their biopsies compared with SS

and non-SS controls. They scored highly on visual

analogue scales of symptoms but had few objective

signs. All were negative for anti-Ro and anti-La

although the prevalence of antinuclear antibodies

(19%) was increased compared with a normal population.

There was no excess of SS-associated tissue types.

CONCLUSION: There was no evidence that age, salivary

gland atrophy or subclinical SS accounted for the

symptoms in DEMS. Most of the patients fitted into a

spectrum of disease which tended more towards

fibromyalgia and/or chronic fatigue syndrome.

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