J Rheum Dis.  2015 Jun;22(3):167-174. 10.4078/jrd.2015.22.3.167.

Extraglandular Manifestations in Korean Patients with Primary Sjogren's Syndrome

• Choi BY
• Yoo JJ
• Oh HJ
• Jang YJ
• Lee YJ
• Song YW

• KMID: 2222882
• DOI: http://doi.org/10.4078/jrd.2015.22.3.167

Abstract

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.

Keyword

Sjogren's syndrome; Extraglandular manifestation; Beta 2-microglobulin; Lymphoma

MeSH Terms

beta 2-Microglobulin
Consensus
Diagnosis
Erythrocyte Indices
Female
Humans
Immunoglobulin G
Lymphoma
Male
Peripheral Nervous System Diseases
Raynaud Disease
Rheumatic Diseases
Seoul
Sjogren's Syndrome*
Immunoglobulin G
beta 2-Microglobulin

Figure

• 

  Figure 1. The correlation of serum β2-microglobulin (β2-M) concentration with European League against Rheumatism (EULAR) Sjögren' s Syndrome Disease Activity Index (ESSDAI) (A), erythrocyte sediment rate (ESR) (B) and serum immunoglobulin G (IgG) (C) in 238 patients with primary Sjögren' s syndrome.

• 

  Figure 2. The comparison of serum β2-microglobulin (β2-M) levels (A) and erythrocyte sediment rate (ESR) (B) between primary Sjögren' s syndrome patients with and without extraglandular manifestation (EM).

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