Sjögren-Type Syndrome After Allogeneic Bone-Marrow Transplantation

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Abstract
Four patients, treated for hematologic disorders with bone-marrow [BM] transplants from HLA-identical siblings, spontaneously complained of dry eyes 8-12 mo. after transplantation. Four allograft recipients and 2 recipients of autologous bone-marrow transplants were evaluated for xerophthalmia and xerostomia. Three allogeneic marrow recipients had evidence of keratoconjunctivitis sicca, and 2 had decreased parotid gland function. All 4 allograft recipients had minor salivary gland histopathology identical to that of Sjogren''s syndrome. The severity of symptoms and histologic lesions corresponded with the severity of chronic graft vs. host disease. One patient developed sclerodermatous skin changes, another had discoid lupus erythematosus and 2 patients had laboratory evidence of cholestasis. None of the patients had autoantibodies but all had hypergammaglobulinemia. None of the recipients of autologous bone marrow had clinical, laboratory or histologic findings resembling Sjogren''s syndrome.