Extraglandular Manifestations and Autoantibodies of Korean Patients with Primary Sjogren's Syndrome

Soo-Hong Seo; Hyun-Sook Kim; Seung-Ki Kwok; Ji Hyeon Ju; Sang-Hyon Kim; Chong-Hyeon Yoon; Ho-Youn Kim; Sung-Hwan Park

doi:10.4078/jkra.2007.14.1.43

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Seo, Kim, Kwok, Ju, Kim, Yoon, Kim, and Park: Extraglandular Manifestations and Autoantibodies of Korean Patients with Primary Sjogren's Syndrome

Original Article

J Korean Rheum Assoc 2007;14(1):43-50.

Published online: 23 March 2007

DOI: https://doi.org/10.4078/jkra.2007.14.1.43

Extraglandular Manifestations and Autoantibodies of Korean Patients with Primary Sjogren's Syndrome

Soo-Hong Seo, M D., Hyun-Sook Kim, M.D.^∗, Seung-Ki Kwok, M.D.^∗, Ji Hyeon Ju, M.D.^∗, Sang-Hyon Kim, M.D.^∗∗, Chong-Hyeon Yoon, M.D.^∗, Ho-Youn Kim, M.D.^∗, Sung-Hwan Park, M.D^∗

Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan

^∗Division of Rheumatology, Department of Internal Medicine, The Catholic University of Korea School of Medicine, Gwangju, Seoul, Korea

^∗∗Division of Rheumatology, Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea

Received 23 October 200614 December 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective:

To investigate the extraglandular manifestations and serological features of Korean patients with primary Sjogren's syndrome (pSS).

Methods:

Clinical and laboratory data of 125 patients with pSS attending rheumatology clinic of Kangnam St. Mary's hospital, with a mean followup period of 64.8 months, were assessed retrospectively.

Results:

Arthralgia was the most common extraglandular manifestation of pSS. Other extraglandular manifestations, such as myalgia, peripheral neuropathy, Raynaud's phenomenon, and hypothyroidism were frequently presented, but lymphoma was rare manifestation in Korean patients with pSS. Some extraglandular manifestations of pSS were associated with hypocomple- mentemia and antibodies against Ro, and La, and antinuclear antibody.

Conclusion:

The clinical manifestations and extraglandular manifestations of Korean patients with pSS patients were similar to other studies except low prevalence of lymphoma. Positivity of anti-Ro/SS-A, anti-La/SS-B antibodies and hypocomplementemia were closely associated with extraglandular manifestations in patients with pSS.

Keywords: Primary Sjjgren's syndrome, Extraglandular manifestation, Autoantibody, Hypocomplementemia

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Table 1.

Patients characteristics and clinical manifestations of primary Sjogren's syndrome

	Number of patients (%)	Mean ± SD (range)
Age (year)		48.60 ±11.54
		(17-83)
Sex (male : female)	4 : 121
	(3.2 : 96.8)
Followup (year)		5.34 ±4.52
		(0.7-25.7)
Ocular symptom	122/125 (97.6)
Positive response of Schimer's I test	114/125 (91.2)
Dry mouth symptom	123/125 (98.4)
Parotid gland swelling	8/125 (6.4)
Positive response of salivary gland scan	109/116 (93.96)
Histopathology of minor salivary gland	27/34 (75)

SD: standard deviation

Table 2.

Extraglandular manifestations in primary Sjogren's syndrome

	Number of patients (%)
Arthralgia/Arthritis	82/125 (65.6)
Myalgia	46/125 (36.8)
Raynaud's phenomenon	30/125 (24.0)
Peripheral neuralgia	29/125 (23.2)
Dry skin (itching sense)	24/125 (17.6)
Hypothyroidism	16/125 (12.8)
Alopecia	15/125 (12.0)
Central nervous system diseas	8/125 (6.4)
Liver involvement	7/125 (5.6)
Skin purpura	7/125 (5.6)
Lung nodule	6/125 (4.8)
Interstitial lung disease	6/125 (4.8)
Vasculitis	5/125 (4.0)
Hyperthyroidism	4/125 (2.7)
Renal tubular acidosis	2/125 (1.6)
Lymphoma	2/125 (1.6)

Table 3.

Autoantibodies in primary Sjogren's syndrome

Autoantibody	Number of patients (%)
Antinuclear antibody	101/125 (80.8)
Rheumatoid factor	99/125 (79.2)
Anti-Ro/SS-A antibody	90/125 (72.0)
Anti-La/SS-B antibody	38/125 (30.4)
Anti-CCP antibody	5/125 (4.0)

Table 4.

Correlation with clinical manifestation

	ANA	RF	Anti-Ro/SS-A	Anti-La/SS-B	Hypo C3	Hypo C4
Arthralgia	NS	p< 0.05∗	NS	NS	NS	NS
Peripheral neurralgia	NS	NS	NS	p< 0.05∗	NS	NS
Raynaud's phenomenon	NS	NS	NS	NS	NS	NS
Arthritis	NS	NS	p=0.091∗	p=0.071∗	NS	NS
Hypothyroidism	NS	NS	NS	NS	NS	p< 0.05∗
Liver involvement	NS	NS	p< 0.05∗	p< 0.05∗	NS	p< 0.05∗
Skin purpura	NS	NS	p< 0.05∗	p< 0.05∗	NS	NS
Interstitial lung disease	NS	NS	NS	NS	NS	p< 0.05∗
Leukopenia	NS	NS	p< 0.05∗	p< 0.05∗	p< 0.05∗	NS
Thrombocytopenia	p<0.05∗	NS	NS	NS	NS	p< 0.05∗

ANA: antinuclear antibody, RF: rheumatoid factor, C3: third component of complement, C4: fourth component of complement, NS: not significant. ∗p values by Chi-squared test or Fisher's exact test

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