Extraglandular Manifestations in Korean Patients with Primary Sjogren's Syndrome

OBJECTIVES: To investigate the clinical findings upon initial diagnosis and extraglandular manifestations in Korean patients with primary Sjogren's syndrome (pSS). METHODS: We collected clinical and laboratory data from 238 pSS patients enrolled at Seoul National University Hospital, Seoul National University Bundang Hospital and Seoul Medical Center from March 2011 to December 2014. All patients met the American-European Consensus Group criteria for pSS. RESULTS: Upon initial diagnosis, sicca symptoms (xerophthalmia or xerostomia) as the chief complaint were only observed in 129 (54.2%) pSS patients, while extraglandular manifestation was more common as the chief complaint in male patients or those with younger age (<40 years) than female or older patients (both p<0.05). Extraglandular manifestations were found in 178 (74.8%) patients, with musculoskeletal manifestations being most common (53.8%). Peripheral neuropathy in pSS patients was associated with Raynaud phenomenon and elevated serum total immunoglobulin G (IgG) levels (both p<0.05). Serum beta2-microglobulin (beta2-M) levels were significantly correlated with European League against Rheumatism (EULAR) Sjogren's syndrome disease activity index, erythrocyte sedimentation rate and serum total IgG (all p<0.001), and were higher in patients with extraglandular manifestations than those without (p<0.05). Serum C3 levels were decreased in patients with extraglandular manifestation, compared to those without (p<0.05). Malignant lymphoma was found in Korean pSS patients (1.7%) and associated with elevated serum beta2-M levels (p<0.0001). CONCLUSION: Extraglandular manifestations were common in pSS patients and may be a diagnostic tool for male or younger pSS patients. Serum beta2-M levels can be useful markers for monitoring pSS patients.

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

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 follow-up 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 hypocomplementemia 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.