title: Increased frequency of Sjögren's syndrome in patients with spondyloarthropathy.
abstract: OBJECTIVE
  To determine the prevalence of sicca symptoms and Sjögren's syndrome (SS) in spondyloarthropathy (SpA) patients with ankylosing spondylitis (AS) and undifferentiated SpA (uSpA).
  
  
  METHODS
  Patients with SpA with inflammatory back pain and/or peripheral arthritis presenting to the university outpatient clinic were diagnosed as AS (n = 40) and uSpA (n = 65) according to established criteria. Patients with SpA with sicca symptoms and/or positive antinuclear antibody (ANA) were investigated for SS by minor salivary gland biopsy and/or sialography. To assess sicca symptoms in this cohort systematically we mailed a validated questionnaire with 6 questions on dryness of eyes and mouth to all 105 SpA patients and 150 healthy controls, a positive answer to > or = 3 questions was taken as suggestive of SS. There was no significant difference in baseline characteristics between patients and controls.
  
  
  RESULTS
  In 8/105 SpA patients (5 uSpA, 3 AS; 6 female, 2 male) SS diagnosis by the European criteria indicated a frequency of 7.6%. Of 105 SpA patients, 12 were ANA+ (11.4%), of whom 7 had SS; thus, ANA were detected in 7/8 SpA patients with SS (88%). Of the 84 SpA patients responding to the questionnaire (80%), 10 gave a positive answer to > or = 3 questions (11.9%) compared to 2 of 131 (1.5%) controls (87.3%) (odds ratio = 8.7, 95% CI 2.3-32.5, p < 0.01).
  
  
  CONCLUSIONS
  The data suggest increased prevalence of sicca symptoms and SS in SpA patients with AS and uSpA. The occurrence of a secondary SS in a variety of inflammatory diseases suggests that salivary gland involvement in these conditions results from as yet unidentified shared pathogenic mechanisms resulting in nonspecific inflammation in this location.
authors.affiliation: Department of Nephrology and Rheumatology, Klinikum Benjamin Franklin, Freie Universität Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Brandt
authors.forename: M
authors.initials: M
authors.lastname: Rudwaleit
authors.forename: U
authors.initials: U
authors.lastname: Eggens
authors.forename: A
authors.initials: A
authors.lastname: Mertz
authors.forename: A
authors.initials: A
authors.lastname: Distler
authors.forename: J
authors.initials: J
authors.lastname: Sieper
authors.forename: J
authors.initials: J
authors.lastname: Braun
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000453:epidemiology