A Clinical Study of Sjögren's Syndrome

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Abstract
The clinical records of 52 patients with Sjogren''s syndrome were reviewed, and the diagnosis in each case designated as definite, probable, or possible Sjogren''s syndrome on the basis of predetermined criteria. Patients with definite Sjogren''s syndrome demonstrated objective evidence of rheumatoid arthritis, keratoconjunctivitis sicca and swelling or atrophy of the salivary glands. Two of these abnormalities were required for a diagnosis of probable Sjogren''s syndrome. Objective evidence of one of these abnormalities plus the presence of subjective complaints suggesting another was deemed sufficient evidence for a diagnosis of possible Sjogren''s syndrome. The group studied exhibited a higher incidence of splenomegaly, Raynaud''s phenomenon, and leukopenia and demonstrated more pronounced abnormalities in serum proteins than found in patients with rheumatoid arthritis alone. The patients with Sjogren''s syndrome were similar to patients with rheumatoid arthritis in regard to: age at onset of the first symptom, incidence of anemia, blood eosinophilia, thyroid enlargement, and subcutaneous nodules; and incidence of positive tests for the rheumatoid and L.E. cell factors. A wide variation in disease pattern was found in the 52 patients. Some cases presented as a variant of rheumatoid arthritis while others more closely resembled scleroderma or systemic lupus erythematosus. The latter observation suggested that Sjogren''s syndrome could best be characterized as a broad spectrum of disease rather than as a discrete disease entity.