Doctoral Student of the Postgraduate Program in Neurology (PPGNEURO), Federal University of the State of Rio de Janeiro - UNIRIO, Rio de Janeiro, RJ, Brazil.
Federal University of the State of Rio de Janeiro - UNIRIO, Rio de Janeiro, RJ, Brazil.
Mult Scler Relat Disord. 2022 Jun;62:103783. doi: 10.1016/j.msard.2022.103783. Epub 2022 Mar 30.
The relationship between primary Sjögren syndrome (pSS) and demyelinating diseases is still not well understood. These diseases seem to coexist amidst autoimmunity, raising questions about clinical characteristics, relationship with immunomodulatory treatment, and possible common immunological background underlying their pathogenesis.
calculate the frequency of dry oral and ocular manifestations and autoantibodies characteristic of primary Sjögren's Syndrome in Multiple Sclerosis.
202 patients with multiple sclerosis answered a questionnaire to identify complaints of xerostomia and xerophthalmia, according to diagnostic criteria for primary Sjögren's syndrome; 43 answered positively to at least one question; 27 had comorbidities or used drugs that cause dry symptoms and were excluded; 16 patients were selected for examinations for oral, ocular and serum anti-Ro/SS-A autoantibody evaluation.
Eleven (68.75%) patients complained of xerostomia; 14 (87.5%) of xerophthalmia. Sialometry < 0.1 ml/min was observed in three (18.8%); 13 patients underwent minor salivary gland biopsy and histopathological examination: focal score > 1 in three (23.1%). Schirmer test was < 5 mm/5 min in four (25%). Lyssamine green/fluorescein dye score was > 5 in three (18.8%). Anti-Ro/SS-A > 10 UI/mm in two (12.5%). Three (1,49%) patients met current criteria for primary Sjögren's syndrome.
Patients with MS may report xerostomia and/or xerophthalmia even in the absence of comorbidities and use of medications capable of causing these symptoms, which may fulfill the diagnostic criteria for pSS. In this study, the frequency of pSS according to current criteria was within the range observed in the literature with older criteria. But the question remains whether the association between these diseases is fortuitous or whether there is a pathogenic link.
原发性干燥综合征（pSS）与脱髓鞘疾病之间的关系仍未得到很好的理解。这些疾病似乎在自身免疫中同时存在，这引发了关于临床特征、与免疫调节治疗的关系以及潜在发病机制的共同免疫学背景的问题。
计算多发性硬化症中干燥口腔和眼部表现以及原发性干燥综合征特征性自身抗体的频率。
202 名多发性硬化症患者回答了一份问卷，以根据原发性干燥综合征的诊断标准识别口干和眼干的主诉；43 名患者至少对一个问题回答为是；27 名患者存在共病或使用可引起干燥症状的药物，被排除在外；16 名患者接受了口腔、眼部和血清抗 Ro/SS-A 自身抗体评估的检查。
11 名（68.75%）患者主诉口干；14 名（87.5%）主诉眼干。唾液流量<0.1ml/min 见于 3 名（18.8%）患者；13 名患者接受了小唾液腺活检和组织病理学检查：3 名（23.1%）患者的焦点评分>1。Schirmer 测试<5mm/5min 见于 4 名（25%）患者。丽丝胺绿/荧光素染色评分>5 见于 3 名（18.8%）患者。抗 Ro/SS-A>10 UI/mm 见于 2 名（12.5%）患者。3 名（1,49%）患者符合原发性干燥综合征的现行标准。
即使没有共病和使用可引起这些症状的药物，MS 患者也可能报告口干和/或眼干，这可能符合 pSS 的诊断标准。在本研究中，根据现行标准，pSS 的频率处于文献中使用旧标准时的范围内。但问题仍然是这些疾病之间的关联是偶然的还是存在发病机制的联系。
