Vol. 14 No. 2 (2022): Arch Pub Health
Clinical Science

Secondary Sjogren’s Syndrome in patients with rheumatoid arthritis

Filip Gucev
University Clinic for Rheumatology; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Ljubinka Damjanovska
University Clinic for Rheumatology; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Georgi Bozhinovski
University Clinic for Rheumatology; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Snezhana Perchinkova-Mishevska
University Clinic for Rheumatology; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Natali Jordanovska-Guceva
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia

Published 2022-12-30

Keywords

  • Sjogren’s syndrome,
  • rheumatoid arthritis ,
  • disease activity

How to Cite

1.
Gucev F, Damjanovska L, Bozhinovski G, Perchinkova-Mishevska S, Jordanovska-Guceva N. Secondary Sjogren’s Syndrome in patients with rheumatoid arthritis. Arch Pub Health [Internet]. 2022 Dec. 30 [cited 2024 Nov. 5];14(2):72-7. Available from: https://id-press.eu/aph/article/view/6017

Abstract

Secondary Sjogren’s syndrome (sSS) is a connective tissue disease characterized by xeropthalmia and xerostomia, associated with another autoimmune disease. The prevalence of sSS in patients with rheumatoid arthritis (RA) is different in different countries, but is assumed at 10% of all RA patients and 20% of these have sub-clinical manifestations. This is a large subpopulation of patients with RA, especially taking into account that the clinical implications of their coexistence are not well explored. Aims: To analyze the effects of sSS on RA, the association between this syndrome and disease activity and disease evolution, presence of serological and immunological markers, disease duration and quality of life in patients with RA. Material and methods: We examined 42 patients, at the age of 18 to 70 years, diagnosed according to the criteria for classification and diagnosis by EULAR (2010). Twenty patients were diagnosed with RA and sSS, and 22 patients with RA without sSS. The groups were comparable regarding age, sex and disease duration. We analyzed the incidence of sSS, association with age, sex, demographic data, disease duration, extraarticular manifestations, and serologic tests (positive RF, anti-CCP) were also made. Disease activity was assessed by disease activity score (DAS28) and quality of life by the health assessment questionnaire-disability index (HAQ-DI). The number of tender and swollen joints was assessed, as well as pain level by using the visual analogue scale (VAS), sedimentation rate (ESR), CRP, and immunological tests(SSA, SSB, antidsDNA, ANA, antiU1snRNP) were also made. Results: In the analyzed patients there was no statistically significant difference in ESR, CRP, DAS28, HAQ-DI, seropositivity of RF and anti-CCP and the presence of antidsDNA, ANA or antiU1snRNP and disease duration. Patients in the RA group had more tender, swollen joints and VAS. There was a statistically significant difference in SSA and SSB levels. There was no significant difference in the treatment of patients from both groups.Conclusion: There was no statistically significant difference in the level of disease activity and quality of life in patients with RA compared to sSS group.

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References

  1. Jonsson R, Haga H-J, Gordon T. Sjogren’s syndrome. In Koopeman WJ (ed.) Arthritis and Allied Conditions. A Textbook of Rheumalology, 14th edn, 2001; pp 1736–59. Lippincott & Williams & Wilkins, Philadelphia, PA.
  2. Lazarus MN, Isenberg DA. Development of additional autoimmune diseases in a population of patients with primary Sjogren’s syndrome. Ann Rheum Dis 2005; 64(7): 1062–1064. DOI: https://doi.org/10.1136/ard.2004.029066
  3. Carmona L, Gonzales-Alvaro I, Balsa A, et al. Rheumatoid arthritis in Spain: оccurrence of extra-articular manifestations ad estimates of disease severity. Ann Rheum Dis 2003; 62(9): 897–900. DOI: https://doi.org/10.1136/ard.62.9.897
  4. Young A, Koduri G. Extra-articular manifestations and complications of rheumatoid arthritis. Best Pract Res ClinRheumatol 2007; 21(5): 909–927. DOI: https://doi.org/10.1016/j.berh.2007.05.007
  5. Uhlig T, Kvien TK, Jensen JL, et al. Sicca symptoms, saliva and tear productions, and disease variables in 636 patients with rheumatoid arthritis. Ann Rheum Dis 1999; 58(7): 415–422. DOI: https://doi.org/10.1136/ard.58.7.415
  6. Skoumal M, Wottawa A. Long term observation study of Austrian patients with rheumatoid arthritis. Acta Med Austriaca 2002; 29(2): 52–56. DOI: https://doi.org/10.1046/j.1563-2571.2002.01043.x
  7. Kauppi M, Pukkala E, Isoma¨ki H. Elevated incidence of hematologic malignancies in patients with Sjogren’s syndrome compared with rheumatoid arthritis (Finland). Cancer Causes Control 1997; 8(2): 201–204. DOI: https://doi.org/10.1023/A:1018472213872
  8. Martens PB, Pillemer S, Jacobsson LTH, et al. Survivorship in a population based cohort of patients with Sjogren’s syndrome 1976–1992. J Rheumatol 1999; 26(6): 1296–1300.
  9. Turesson C, O’Fallon WM, Crowson C, et al. Occurrence of extra-articular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol 2002; 29(1): 62–67.
  10. Calguneri M, Ureten K, AkifOzturk M, et al. Extraarticular manifestations of rheumatoid arthritis: results of a university hospital of 526 patients in Turkey. ClinExpRheumatol 2006; 24(3): 305–308.
  11. Haga HJ, naderi Y, Moreno AM, Peen E. A study of the prevalence of sicca symptoms and secondary Sjogren’s syndrome in patients with rheumatoid arthritis, and its association to disease activity and treatment profile. Int J Rheum Dis. 2012;15(3):284-288. DOI: https://doi.org/10.1111/j.1756-185X.2012.01717.x
  12. Drosos AA, Lanchbury JS, Panayi GS. Rheumatoid arthritis in Greek and British patients. A comparative clinical, radiology and serology study. Arthritis Rheum 1992;35(7):745-8. DOI: https://doi.org/10.1002/art.1780350705
  13. Asmussen KH, Bowman SJ. Outcome measures in Sjogren’s syndrome. Rheumatology (Oxford), 2001; 40(10): 1085–1088. DOI: https://doi.org/10.1093/rheumatology/40.10.1085