Background Sjogren’s syndrome (SS) is characterized by lymphocyte proliferation and progressive exocrine gland damage, which can be accompanied by multi-system damage, but there is a lack of research on the combination of clinical manifestations, autoantibodies and labial gland pathological characteristics of outpatients with SS.
Objective To investigate the clinical manifestations, autoantibodies and labial gland pathology of patients with SS and provide clinical data for outpatients with SS.
Methods Clinical and pathological data of 195 patients with SS including primary Sjogren’s syndrome (pSS) and secondary Sjogren’s Syndrome (sSS) who all underwent labial biopsy were collected from outpatient clinic of the First Affiliated Hospital of Air Force Medical University from June 2020 to April 2021.
Results There were 183 females and 12 males aged 20-85 (49.7 ± 14.0) years. Of the 166 patients with pSS, 30.3% of patients had involvement of hematological system including leukopenia and/or thrombocytopenia. Involvements of lung, skin, nervous system and kidney were seen in 23%, 16.3%, 7.8% and 6.6% of the patients, respectively. Of these patients, 98.2% had positive ANA, and the antibody positivity rates of anti-SSA, anti-Ro52 and anti-SSB antibodies were 83.1%, 83.1%, 34.9%, respectively. All patients with positive anti-SSB antibody were positive for anti-SSA antibody. Anti-AMA-M2, anti-nRNP/Sm, anti-CENP-B and anti-thyroid-related antibodies were positive in 11.4%, 10.2%, 8.4% and 39.5% of the pSS patients, respectively. In labial gland pathology, FS ≥ 1, degree of SSⅠ/Ⅰ～Ⅱ, chronic sialadenitis and normal were seen in 44%, 29.5%, 13.9% and 12.7% of pSS patients, respectively. Of the 29 sSS patients, there were 22 (75.9%) cases with RA. The other cases were SLE (2 cases), SSc (2 cases), MCTD (2 cases) or Takayasu arteritis (1 case). The positive rate of anti-SSA was 58.6% in sSS. There were no differences in incidence rates of dry mouth, dry eye, rampant caries, parotid swelling, positive Schirmer test or abnormal unstimulated salivary flow rate between the pSS group and the sSS group (all P > 0.05). Compared with the sSS group, patients in the pSS group had higher rate of anti-SSA antibodies (83.1% vs 58.6%, P=0.002). In labial gland pathology examination, compared with the sSS group, the number of patients with FS ≥ 1 was significantly greater in the pSS group(44.0% vs 24.1%, P=0.045), while patients with degree of SSⅠ/Ⅰ～Ⅱ was significantly less (29.5% vs 51.7%, P=0.019), and there were no significant differences in the prevalence of chronic sialadenitis between the two groups (P > 0.05).
Conclusion The proportion of patients with positive anti-SSA antibody and FS ≥ 1 is higher in pSS as compared with sSS. Positive anti-SSB antibody generally accompanies positive anti-SSA antibody. Positive anti-AMA-M2, anti-nRNP/Sm and anti-CENP-B antibodies are common in SS patients.
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