Rheumatology: These Comorbidities of Sjögren's Syndrome You Need to Know

Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease that mainly affects exocrine glands such as lacrimal and salivary glands, and manifests as dry mouth, dry eyes, rampant dental caries, and sialadenitis

Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease that mainly affects exocrine glands such as lacrimal and salivary glands, and manifests as dry mouth, dry eyes, rampant dental caries, and sialadenitis

 

Image source: Baidu Gallery

Image source: Baidu Gallery

From a large number of clinical, epidemiological, prognostic, and survey studies, cardiovascular disease, infection , musculoskeletal disease, and malignancy ( except lymphoma ) are probably the most relevant complications of pSS

Cardiovascular disease, infection , musculoskeletal disease and malignancy cardiovascular disease, infection , musculoskeletal disease and malignancy Vascular infection ( except lymphoma ) may be pSS

Prevalence and risk of major comorbidities associated with pSS Prevalence and risk of major comorbidities associated with pSS

Source: DOI: 10.

Source: DOI: 10.

Cardiovascular events and cancer rates were lower

Infections (especially oral candidiasis) and fibromyalgia are very common in the clinic

Infections (especially oral candidiasis) and fibromyalgia are very common in the clinic

Infections (especially oral candidiasis) and fibromyalgia are very common in the clinic

Cardiovascular events and cancer rates were lower

Cardiovascular events and cancer rates were lower

Cardiovascular disease is considered to be one of the most important complications of systemic autoimmune diseases such as RA and SLE.

1.

Hypercholesterolemia , hypertension , diabetes , and hypertriglyceridemia are the most common cardiovascular risk factors for pSS .

2.

(1) A large number of case-control studies have shown that the mean arterial intima-media thickness of pSS is significantly higher than that of healthy individuals of the same age and sex (that is, there is a possibility of preclinical atherosclerosis);

(2) A multivariate analysis model incorporating traditional cardiovascular risk factors also pointed out that pSS was an independent risk factor for arterial wall thickening, with an odds ratio of 2.
8 (that is, arterial wall thickening in patients with pSS was 2.
8 in the normal population).
times);

(2) A multivariate analysis model incorporating traditional cardiovascular risk factors also pointed out that pSS was an independent risk factor for arterial wall thickening, with an odds ratio of 2.
8 (that is, arterial wall thickening in patients with pSS was 2.
8 in the normal population).
times);

(3) Pulse wave velocity (PWV) refers to the pressure wave transmission velocity propagating along the wall of the aorta generated by the ejection of each heart beat.
assessment
.
A large number of clinical controlled studies have also shown that the pulse wave velocity of pSS patients is significantly higher than that of the same age and same gender control subjects;

(3) Pulse wave velocity (PWV) refers to the pressure wave transmission velocity propagating along the wall of the aorta generated by the ejection of each heart beat.
assessment
.
A large number of clinical controlled studies have also shown that the pulse wave velocity of pSS patients is significantly higher than that of the same age and same gender control subjects;

(4) The risk of preclinical atherosclerosis is higher in pSS patients with positive antibody (ANA, a-Ro, RF) and long course (duration > 10 years);

(4) The risk of preclinical atherosclerosis is higher in pSS patients with positive antibody (ANA, a-Ro, RF) and long course (duration > 10 years);

3.
Cardiovascular events

3.
Cardiovascular events 3.
Cardiovascular events The overall risk of cardiovascular disease or cerebrovascular events was significantly increased in patients with pSS
.
Cardiovascular disease is the leading cause of death in patients with pSS
.
In conclusion, with regard to cardiovascular disease, there is clinical evidence that patients with pSS are at increased risk of preclinical atherosclerosis
.
In addition, there was an increased risk of clinical cardiovascular events in patients with pSS
.
musculoskeletal complications

 

Clinical studies have shown that the prevalence of fibromyalgia in patients with pSS is about 12-31% , which is higher than that of the general population and significantly higher than that of other systemic autoimmune diseases such as SLE
.

Clinical studies have shown that the prevalence of fibromyalgia in patients with pSS is about 12-31%, and the prevalence of fibromyalgia in patients with pSS is about 12-31% , which is higher than that of the general population and significantly higher than other systemic autoimmune diseases such as SLE
.

No clinical study has found that the prevalence of osteoporosis
and fractures in patients with pSS is significantly different from that in healthy people .

No clinical study has found that the prevalence of osteoporosis
and fractures in patients with pSS is significantly different from that in healthy people .
Osteoporosis

 

 

infection infection

Studies have shown that infection is one of the possible causes of pSS , especially the infection of viruses (such as HIV, HCV, HTLV1, EBV, CMV, parvovirus B19)
.

Studies have shown that infection is one of the possible causes of pSS infection is one of the possible causes of pSS , especially the infection of viruses (such as HIV, HCV, HTLV1, EBV, CMV, parvovirus B19)
.
As for the complications of pSS, this paper mainly discusses the two aspects of specific infection and severe infection
.

1.
Specific infection

1.
Specific infection 1.
Specific infection

(1) Oral infection

(1) Oral infection (1) Oral infection

Oral infections in patients with pSS are common in daily clinical practice
.
Among them, oral Candida infections are more common
.
There was a significant negative association between unstimulated salivary flow and Candida infection (ie, the more severe the symptoms of dry mouth, the greater the susceptibility to oral infection)
.

Oral infections in patients with pSS are common in daily clinical practice
.
Among them, oral Candida infections are more common
.
There was a significant negative association between unstimulated salivary flow and Candida infection (ie, the more severe the symptoms of dry mouth, the greater the susceptibility to oral infection)
.

(2) Mycobacterium tuberculosis infection

(2) Mycobacterium tuberculosis infection (2) Mycobacterium tuberculosis infection

A large number of case-control studies have shown that patients with pSS have a significantly increased risk of TB
.
Mainly due to an increased risk of tuberculosis
.
Age >= 60 years and steroid use (eg, prednisolone >= 5 mg/day) are major risk factors for developing tuberculosis
.
Infected patients had an increased risk of death compared with pSS patients who were not infected with TB
.

A large number of case-control studies have shown that patients with pSS have a significantly increased risk of TB
.
Mainly due to an increased risk of tuberculosis
.
Age >= 60 years and steroid use (eg, prednisolone >= 5 mg/day) are major risk factors for developing tuberculosis
.
Infected patients had an increased risk of death compared with pSS patients who were not infected with TB
.

(3) Nontuberculous mycobacteria infection

(3) Nontuberculous Mycobacterium infection (3) Nontuberculous Mycobacterium infection

An increased risk of nontuberculous mycobacterial infection was observed in patients with pSS receiving immunosuppressants
.

An increased risk of nontuberculous mycobacterial infection was observed in patients with pSS receiving immunosuppressants
.

In conclusion, it can be considered that the increased risk of these two mycobacterial infections in patients with pSS is more related to the treatment of the disease than to the disease itself
.

In conclusion, it can be considered that the increased risk of these two mycobacterial infections in patients with pSS is more related to the treatment of the disease than to the disease itself
.

2.
Serious infection

2.
Serious infection 2.
Serious infection

Severe infections in pSS patients are mainly respiratory tract infections, bacterial pneumonia and urinary tract infections
.
A 10-year follow-up showed that the prevalence of serious infection in pSS patients (10.
1%) was significantly lower than that in SLE (16.
9%), and it was related to the treatment method, and the difference was not statistically significant when the treatment method was adjusted
.

Severe infections in pSS patients are mainly respiratory tract infections, bacterial pneumonia and urinary tract infections
.
A 10-year follow-up showed that the prevalence of serious infection in pSS patients (10.
1%) was significantly lower than that in SLE (16.
9%), and it was related to the treatment method, and the difference was not statistically significant when the treatment method was adjusted
.
A large number of clinical research literatures on statistical tumors (except lymphoma) have confirmed the correlation between pSS and lymphoma
.
Chronic B-cell activation is likely to be a major factor contributing to the significantly higher incidence of B-cell lymphoma in patients with pSS than in the general population or patients with other autoimmune diseases
.
Chronic B-cell activation is likely to be a major factor contributing to the significantly higher incidence of B-cell lymphoma in patients with pSS than in the general population or patients with other autoimmune diseases
.
However , there is no unified conclusion on whether the risk of malignancy (except lymphoma) is increased in patients with pSS .
There are also clinical studies showing an increased risk of thyroid cancer in patients with pSS , but this remains to be demonstrated .
Some scholars have also suggested that there may be a subtype of pSS patients who are at higher risk for cancer .
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