RESEARCH - Progression of salivary gland dysfunction in patients with Sjögren's syndrome

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ls of the Rheumatic Diseases 2007;66:107-112

© 2007 by BMJ Publishing Group Ltd & European League Against Rheumatism

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EXTENDED REPORT

Progression of salivary gland dysfunction in patients with Sjögren's

syndrome

J Pijpe, W W I Kalk, H Bootsma, F K L Spijkervet, C G M Kallenberg and A

Vissink

University Medical Center Groningen, University of Groningen, Groningen, The

Netherlands

Background: Salivary gland dysfunction is one of the key manifestations of

Sjögren's syndrome.

Objectives: (1) To assess prospectively loss of function of individual

salivary glands in patients with primary and secondary Sjögren's syndrome in

relation to disease duration and use of immunomodulatory drugs. (2) To study

changes in sialochemical and laboratory values and subjective complaints

over time.

Methods: 60 patients with Sjögren's syndrome were included in this study.

Whole and gland-specific saliva (parotid and submandibular/sublingual

(SM/SL)), samples were collected at baseline and after a mean of 3.6 (SD

2.3) years of follow-up. Disease duration was recorded for all patients.

Results: Patients with Sjögren's syndrome with short disease duration had

significantly higher stimulated flow rates at baseline than those with

longer disease duration (p<0.05). When compared with healthy controls, the

decrease in SM/SL flow rates at baseline was more prominent than that in

parotid flow rates (p<0.05). Over time, there was a significant further

decrease of stimulated flow rates, especially of the parotid gland,

accompanied by increasing problems with swallowing dry food (p<0.05). The

decrease was independent of the use of corticosteroids or disease-modifying

antirheumatic drugs (DMARDs). Sialochemical variables remained stable.

Conclusions: Early Sjögren's syndrome is characterised by a decreased

salivary gland function (parotis>SM/SL), which shows a further decrease over

time, regardless of the use of DMARDs or steroids. Patients with Sjögren's

syndrome with longer disease duration are characterised by severely reduced

secretions of both the parotid and SM/SL glands. These observations are

relevant for identifying patients who would most likely benefit from

intervention treatment.

http://ard.bmj.com/cgi/content/abstract/66/1/107?etoc

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