Background An increased risk of tuberculosis (TB) has been found in subjects with Sjögren's syndrome (SS); however, whether TB or nontuberculous mycobacteria (NTM) infection is associated with the risk of SS is still unknown.

Objectives To explore the association between a history of mycobacterial infection and the risk of newly diagnosed SS.

Methods After excluding those who had rheumatoid arthritis and systemic lupus erythematosus, we identified 5,751 newly diagnosed SS cases and 86,265 non-SS patients matched (1:15) for age, sex, and the year of first diagnosis date as controls using nationwide, population-based, claims data. The association between the risk of incident SS and a history of treated mycobacterial infection, including TB and NTM, was quantified by odds ratios (ORs) with 95% confidence intervals (CIs) using conditional logistic regression analysis after adjusting for Charlson comorbidity index (CCI) and bronchiectasis.

Results The mean ± SD age was 55±14 years and the proportion of female gender was 87.8% in newly diagnosed SS cases and non-SS controls. An association was observed between NTM infection (OR, 11.24; 95% CI, 2.37–53.24) and incident SS, but not between TB infection and incident SS (OR, 1.29; 95% CI, 0.97–1.71) after adjustment for CCI and bronchiectasis. The magnitude of the association between NTM and SS risk was greatest among those aged between 45 and 65 years (OR, 39.24; 95% CI, 3.97–387.75).

Conclusions The present study demonstrates a statistically significant association of newly-diagnosed SS with a history of NTM, but not TB infection.

References

1. Peri Y, Agmon-Levin N, Theodor E, et al. Sjogren's syndrome, the old and the new. Best practice & research Clinical rheumatology 2012;26(1):105–17.

2. Mavragani CP, Moutsopoulos HM. The geoepidemiology of Sjogren's syndrome. Autoimmunity reviews 2010;9(5):A305–10.

3. Elkington P, Tebruegge M, Mansour S. Tuberculosis: An Infection-Initiated Autoimmune Disease? Trends in immunology 2016.

References

Acknowledgements The authors would like to thank the Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan, ROC for statistical support.

Disclosure of Interest None declared