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The clinical phenotype of isolated ocular or oral dryness in Sjögren’s disease
L.G. Chatzis1, A.V. Goules2, C. Baldini3, V.C. Pezoulas4, A.I. Venetsanopoulou5, P.V. Voulgari6, D.I. Fotiadis7, F.N. Skopouli8, H.M. Moutsopoulos9, A.G. Tzioufas10
- Pathophysiology Department, Athens School of Medicine, National and Kapodistrian University of Athens, Greece. lukechatzis@gmail.com
- Pathophysiology Department, Athens School of Medicine, National and Kapodistrian University of Athens, Greece.
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
- Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Greece.
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Greece.
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Greece.
- Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, and Department of Biomedical Research, Institute of Molecular Biology and Biotechnology, FORTH, Ioannina, Greece.
- Department of Nutrition and Clinical Dietetics, Harokopio University of Athens, and Department of Medicine and Clinical Immunology, Euroclinic of Athens, Greece.
- Medical Sciences Chair Immunology, Academy of Athens, Greece.
- Pathophysiology Department, Athens School of Medicine, National and Kapodistrian University of Athens; Research Institute for Systemic Autoimmune Diseases, Athens; and Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece.
CER18246
2024 Vol.42, N°12
PI 2507, PF 2512
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PMID: 39661569 [PubMed]
Received: 20/10/2024
Accepted : 04/12/2024
In Press: 11/12/2024
Published: 19/12/2024
Abstract
OBJECTIVES:
To assess if isolated mouth or eye dryness constitutes distinct clinical phenotypes in Sjögren’s disease (SjD).
METHODS:
We analysed 1765 patients meeting the 2016 ACR-EULAR SjD criteria, followed up at four centres in Greece and Italy (Universities of Pisa, Italy, and Athens, Harokopion, and Ioannina, Greece). Patients with isolated mouth or eye dryness were identified and matched 1:2 with those experiencing both symptoms, according to age at SjD diagnosis, gender, and disease duration. We defined two study groups: a) patients with ocular dryness only, and b) patients with oral dryness only, based on the AECG validated questionnaires for dryness. We compared glandular and extra-glandular manifestations, serology, and histologic features between each study and their matched controls.
RESULTS:
Seventy-two patients with isolated ocular dryness and 74 with isolated oral dryness were compared with 144 and 148 matched controls, respectively. Both groups had a median disease duration of 3 years. Patients with isolated eye dryness had lower frequency of salivary gland enlargement (35.4% vs. 28.7%, p=0.05) and lymphoma (0% vs. 11.3%, p=0.001). Conversely, those with isolated oral dryness had lower rates of arthralgias (39.1% vs. 65.5%, p=0.0003) and arthritis (8.6% vs. 20.3%, p=0.05). Isolated oral dryness was associated with older age at SjD diagnosis (median 53.5 vs. 46, p=0.005) and a higher likelihood of lymphoma (9.4% vs. 0%, p=0.01) compared to isolated ocular dryness.
CONCLUSIONS:
Isolated ocular or oral dryness occurs in 8% of the general SjD population. Patients with isolated dry eyes have a lower prevalence of lymphoma compared to those with isolated dry mouth.
