title: Low levels of vitamin-D are associated with neuropathy and lymphoma among patients with Sjögren's syndrome.
abstract: OBJECTIVE
  Primary Sjögren's syndrome (SS) is a chronic autoimmune disease primarily involving the exocrine glands. The clinical picture of SS ranges from exocrinopathy to systemic disease affecting the lung, kidney, liver, skin, musculockeletal and nervous systems. The morbidity of SS is mainly determined by extraglandular disease and increased prevalence of lymphoma. Environmental and hormonal factors, such as vitamin-D may play a role in the pathogenic process and disease expression. Thus, we aimed to evaluate levels of vitamin-D and their association with manifestations of SS.
  
  
  METHODS
  Vitamin-D levels were determined in 176 primary SS patients and 163 matched healthy volunteers utilizing the LIAISON chemiluminescent immunoassays (DiaSorin-Italy). A correlation between vitamin-D levels and clinical and serological manifestations of SS was performed.
  
  
  RESULTS
  Mean vitamin-D levels were comparable between SS patients and control 21.2 ± 9.4 ng/ml and 22.4 ± 10 ng/ml, respectively. Peripheral neuropathy was diagnosed in 23% of SS patients and associated with lower vitamin-D levels (18.6 ± 5.5 ng/ml vs. 22.6±8 ng/ml (p = 0.04)). Lymphoma was diagnosed in 4.3% of SS patients, who had lower levels of vitamin-D (13.2 ± 6.25 ng/ml), compared to SS patients without lymphoma (22 ± 8 ng/ml), (p = 0.03). Other clinical and serological manifestations did not correlate with vitamin-D status.
  
  
  CONCLUSIONS
  In this study, low levels of vitamin-D correlated with the presence of peripheral neuropathy and lymphoma among SS patients. The link between vitamin-D and neuropathy or lymphoma was reported in other conditions, and may support a role for vitamin-D in the pathogenesis of these processes. Plausible beneficial effect for vitamin-D supplementation may thus be suggested.
authors: The Zabludowicz Center for Autoimmune Diseases, The Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.
authors: Nancy
authors: N
authors: Agmon-Levin
authors: Shaye
authors: S
authors: Kivity
authors: Athanasios G
authors: AG
authors: Tzioufas
authors: Marcus
authors: M
authors: López Hoyos
authors: Blaz
authors: B
authors: Rozman
authors: Inga
authors: I
authors: Efes
authors: Yinon
authors: Y
authors: Shapira
authors: Ari
authors: A
authors: Shamis
authors: Howard
authors: H
authors: Amital
authors: Pierre
authors: P
authors: Youinou
authors: Yehuda
authors: Y
authors: Shoenfeld
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000097:blood* / Q000150:complications / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011115:Polyneuropathies / Q000097:blood* / Q000150:complications / Q000276:immunology; D012859:Sjogren's Syndrome / Q000097:blood* / Q000150:complications / Q000276:immunology; D014807:Vitamin D / Q000097:blood* / Q000276:immunology
chemical_list: D014807:Vitamin D