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AB0582 The Frequency of SjÖgren's Syndrome in Celiac Patients; A Cross-Sectional Controlled Clinical Trial
  1. K. Ayar1,
  2. R. Tunç2,
  3. H. Pekel3,
  4. A. Küçük2,
  5. H.H. Esen4,
  6. S. Çifçi5,
  7. H. Ataseven5
  1. 1Rheumatology, Diyarbakır Gazi Yaşargil Research and Education Hospital, Diyarbakır
  2. 2Rheumatology
  3. 3Ophthalmology
  4. 4Pathology
  5. 5Gastroenterology, Necmettin Erbakan Univercity Meram School of Medicine, Konya, Turkey

Abstract

Background Celiac disease and Sjögren's syndrome are autoimmune disorders which can associate with other autoimmune diseases. There isn't any cross sectional controlled study investigating the frequency of Sjögren's syndrome in celiac disease patients in the literature.

Objectives To determine and compare the frequency of Sjögren's syndrome in celiac patients (CP) and healthy controls (HC).

Methods Eighty one CP, all of them were biopsy proven and antibody or genetic proven, included to the study.The study was designed as four-phase cross-sectional investigation. In the first phase sicca symptoms were asked. In the second phase Schirmer-I, tear break up time (TBUT), whole sialometry without stimulation (WSWS) tests were performed to individuals who defined at least one sicca symptom. In the third phase ocular staining score (OSS) was performed, indirect immunofluorescence ANA, RF, anti-Ro, anti-La tests were studied for individuals who had objective findings of sicca. Labial salivary gland biopsy1 (LSGB) was performed in the last phase. Frequency of Sjögren's syndrome was defined according to American-European Consensus Group (AECG) criteria2 and to American College of Rheumatology (ACR) criteria3 in CP and HC. Frequency of Sjögren's syndrome compared between CP and HC

Results One hundred and eighty one (CP/HC; 81/100), 44 (27/17), 26 (18/8) and 19 (13/6) individuals were evaluated in the first, second, third and fourth phases respectively. Mean ages were 40,6±13,4, 39,7±12,5 and 79%, 75% were females in CP, HC respectively. The frequency of dry eye, dry mouth symptoms were 23,5%, 27,2% and 13%, 10% in CP and HC respectively. We found significant differences between groups with dry mouth symptoms (p=0,003) but not with dry eye symptoms (p=0.079). Schirmer I, TBUT, WSWS tests that were evaluated in the second phase were 16,2±12,4 and 14,8±10,3, 11,7±6,0 and 11,7±4,6, 4,3±3,9 and 8,6±5,3 in CP and HC respectively. The results of the tests performed in the third phase shown in table 1. In the last phase 6 CP and 2 HC had grade 3-4 sialoadenitis1 in LSGB. The frequency of Sjögren's syndrome according to ACR, AECG classification criteria were 4,9%, 4,9% and 3%, 2% in CP and HC which were not significantly different.

Table 1.

The results of the tests performed in the third phase

Conclusions Although dry mouth symptoms were more frequent in CP compared to HC, the frequency of Sjögren's syndrome was not significantly different. Increased frequency of dry mouth symptoms maybe related to reasons other then autoimmunity.

References

  1. Chisholm DM, Mason DK. Labial salivary gland biopsy in Sjögren's disease. J Clin pathol. 1968 sep 21(5) 656-60.

  2. Vitali C et al. European Study Group on Classification Criteria. Ann Rheum Dis. 2002 Jun;61(6):554-8. Review.

  3. Shiboski SC et al. American College of Rheumatology classification criteria for Sjögren's syndrome: a data- driven, expert consensus approach in the Sjögren's International Collaborative Clinical Alliance cohort.Arthritis Care Res (Hoboken). 2012 Apr;64(4):475-87.

Disclosure of Interest None declared

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