Characterization of sicca symptoms in patients with Sjögren's syndrome, and reports of six cases lacking subjective sicca features ("subclinical Sjögren's syndrome").

We evaluated seventeen ocular and oral symptoms in patients with Sjögren's syndrome (SjS) to characterize the subjective sicca symptoms of this syndrome. The following eleven symptoms were characteristic in patients with SjS compared with patients with rheumatoid arthritis (RA) or healthy adults.: (1) decreased lachrymation, (2) ocular foreign body sensation, (3) ocular filmy sensation, (4) increased mucous discharge from the eyes, (5) thirsty sensation, (6) decreased salivation, (7) increased dental caries, (8) abnormal sense of taste, (9) difficulty in chewing, (10) dryness of the oral cavity, and (11) increased fluid-intake with meals. Some of the symptoms were detectable in RA patients and healthy adults although the mean number of the positive symptoms was significantly higher in patients with SjS. The demonstration of three or more symptoms, therefore, will be sufficient in the consideration of the definite sicca features for this syndrome. The present studies also confirmed the chronological influence on the development of subjective sicca features in patients with SjS, and support our concept that patients lacking subjective sicca features are those in the early stages of this syndrome. Finally, six cases of SjS lacking subjective sicca features were described.