Extended report
Focal sialadenitis in patients with ankylosing spondylitis and
spondyloarthropathy: a comparison with patients with rheumatoid
arthritis or mixed connective tissue disease
L M J Heleniusa b, J H Hietanenc, I Heleniusd, H Kautiainene, H Piirainenb, L Paimelaf, M Lappalaineng, R Suuronena, C Lindqvista, M Leirisalo-Repob
a Department
of Oral and Maxillofacial Surgery, Helsinki University Central
Hospital, Helsinki, Finland, b Department of Medicine,
Division of Rheumatology, Helsinki University Central Hospital,
Helsinki, Finland, c Department of Oral Pathology,
University of Helsinki, d Department
of Surgery, Päijät-Häme Central Hospital, Lahti, Finland, e Rheumatism Foundation
Hospital, Heinola, Finland, f Invalid Foundation, ORTON, Helsinki, g Department of Virology, Helsinki
University Central Hospital
Correspondence to: Dr Helenius, Ohjaajantie 3 A 4, 00400 Helsinki, Finland lmhelini{at}mappihelsinki.fi
Accepted for publication 21 November
2000
OBJECTIVES
To
investigate the occurrence of and risk factors for focal sialadenitis
in patients with rheumatoid arthritis (RA), mixed connective tissue
disease (MCTD), ankylosing spondylitis (AS), and
spondyloarthropathy (SpA).
METHODSA total of 85 patients (25 with RA, 19 with MCTD, 19 with AS, 22 with SpA)
participated in the study. Each patient filled out a questionnaire for
eye and oral symptoms and for the use of medication, and was
interviewed; other tests included Schirmer's test, laboratory tests,
collection of unstimulated and stimulated whole saliva, and minor
salivary gland biopsy. A focus score of 
1 was regarded as an
indicator of focal sialadenitis.
RESULTSFocal
sialadenitis was observed in 68% (57/84) of all patients. It affected
80% (20/25) of the patients with RA, 94% (17/18) of those with MCTD,
58% (11/19) of those with AS, and 41% (9/22) of those with SpA
(
2 test, p=0.0013). Salivary secretion correlated
negatively with the focus scoresthat is, severity of focal
sialadenitis. Patients with focal sialadenitis had both decreased
salivary secretion and decreased tear secretion significantly more
often than did patients without (2 test, p=0.0074 and
p=0.048 respectively). Patients with positive rheumatoid factor (RF),
antinuclear antibodies (ANA), or SSA or SSB antibodies had sialadenitis
significantly more often than did patients with negative antibodies. In
the subgroup of patients with AS or SpA, no associations were found
between focal sialadenitis and the presence of these antibodies.
CONCLUSIONIn addition
to patients with RA or MCTD, focal sialadenitis also affects a very
high proportion of patients with AS or SpA. Focus scores are
significantly higher in patients with RA or MCTD than in those with AS
or SpA. A significant association exists between focal sialadenitis and
RF, ANA, SSA and SSB. However, in the subgroup of patients with AS or
SpA, no associations were found between focal sialadenitis and
serological markers or clinical symptoms.
© 2001 by Annals of the Rheumatic Diseases
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