Focal sialadenitis in patients with ankylosing spondylitis and spondyloarthropathy: a comparison with patients with rheumatoid arthritis or mixed connective tissue disease.
OBJECTIVE
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).


METHODS
A 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 > or =1 was regarded as an indicator of focal sialadenitis.


RESULTS
Focal 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 (chi(2) test, p=0.0013). Salivary secretion correlated negatively with the focus scores-that 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 (chi(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.


CONCLUSIONS
In 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.
Helenius
L M
LM
Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland. lmhelini@mappihelsinki.fi
Hietanen
J H
JH
Helenius
I
I
Kautiainen
H
H
Piirainen
H
H
Paimela
L
L
Lappalainen
M
M
Suuronen
R
R
Lindqvist
C
C
Leirisalo-Repo
M
M
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000097:blood; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001168:Arthritis / Q000150:complications* / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008947:Mixed Connective Tissue Disease / Q000150:complications* / Q000188:drug therapy; D009391:Nephelometry and Turbidimetry; D011239:Prednisolone / Q000627:therapeutic use; D012217:Rheumatoid Factor / Q000097:blood; D012307:Risk Factors; D012469:Salivary Glands / Q000378:metabolism; D012793:Sialadenitis / Q000209:etiology* / Q000378:metabolism; D013122:Spinal Diseases / Q000150:complications* / Q000188:drug therapy; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000188:drug therapy; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D012460:Sulfasalazine / Q000627:therapeutic use; D013666:Tears / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear; D018501:Antirheumatic Agents; D012460:Sulfasalazine; D012217:Rheumatoid Factor; D011239:Prednisolone