Background Secondary Sjögren’s syndrome is known to occur with rheumatoid arthritis, systemic lupus erythematosus, but apart from a few cases, has not been reported with spondylarthropathy.
Objectives To determine the prevalence of Sjögren’s syndrome in spondylarthropathy patients.
Methods Patients with spondylarthropathy (n = 62) with inflammatory back pain and/or peripheral arthritis were diagnosed as ankylosing spondylitis, undiferentiated spondylarthropathy, psoriatic arthritis and arthritis associated with inflammatory bowel disease. The investigation of sicca symptoms in the spondylarthropathy group and healthy controls (n = 102) was based on a valited questionnaire. Patients with spondylarthropathy with sicca symptomes and/or positive antinuclear antibodies (ANA) were investigated for Sjögren’s syndrome by minor salivary gland biopsy.
In the spondylarthropathy group, the laboratory variables were: HLA B27, HLA DR, DQ, anti ENA, serology hepatitis B, C.
Results In 17/62 patients (11 undifferentiated spondylarthropathy,5 ankylosing spondylitis,16 females,1 male) Sjögren’s syndrome diagnosis by the europeans criteria indicated a frequency of 27,4%. Of 62 spondylarthropathy,12 were ANA positive (19,3%), of whom 5 had Sjögren’s syndrome. ANA were detected in 8/17(47%) patients with Sjögren’s syndrome. Of 62 spondylarthropathy patients,20 had sicca symptoms (32,2%), compared to 3 of 102 (2,9%) controls. HLA B27 is positive in 12/17 patients (70,5%). The results of the study of HLA DR, DQ seem to show an high frequency of HLA DR4, and DQ3 in the association group, but the difference is not significative.
Conclusion The frequency of Sjögren’s syndrome is 27,4%in the spondylarthropathy group, thus more than in controls. The association Sjögren’s syndrome and spondylarthropathy seems to be not fortuitous, and the HLA class II study seems to show a probable genetic predisposition.
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