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. 1998 Jan;57(1):20–24. doi: 10.1136/ard.57.1.20

Weak association between subjective symptoms of and objective testing for dry eyes and dry mouth: results from a population based study

E Hay 1, E Thomas 1, B Pal 1, A Hajeer 1, H Chambers 1, A Silman 1
PMCID: PMC1752470  PMID: 9536818

Abstract

OBJECTIVES—To determine associations between symptoms of dry eyes and dry mouth and objective evidence of lacrimal and salivary gland dysfunction in a population based sample. To determine associations between these elements and the presence of autoantibodies.
METHODS—A cross sectional population based survey. Subjects were interviewed and examined (Schirmer-1 test and unstimulated salivary flow) for the presence of dry eyes and mouth. Antibodies (anti-Ro [SS-A], anti-La [SS-B], rheumatoid factor, antinuclear antibody) were measured.
RESULTS—341 subjects were examined. Twenty four per cent had dry eye symptoms, 29% dry mouth symptoms, and 14% both. There was only a weak association between the presence of oral or ocular symptoms and their respective test results. Associations were strongest between dry mouth symptoms and positive test results, and in subjects under 55 years of age. There was no association between the presence of autoantibodies and either symptoms or signs of dry eyes or dry mouth.
CONCLUSION—Only weak associations were found between self reported symptoms of dry eyes and dry mouth and objective measures said to define Sjögrens syndrome in the general population. The clinical significance of these symptoms in the community needs reappraisal.

 Keywords: Sjögrens syndrome; Schirmer's test; keratoconjunctivitis sicca; xerostomia

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Figure 1  .

Figure 1  

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Combinations of ocular and oral symptoms. Numbers represent subjects classified as having symptoms of dry eyes (ocular) and dry mouth (oral).

Figure 2  .

Figure 2  

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Combination of ocular symptoms. Numbers represent subjects answering positively to each of the questions about dry eyes and dry mouth listed in table 1. "Dry eyes"= question 1a; "gritty eyes"= question 1b; "tear substitutes"= question 1c.

Figure 3  .

Figure 3  

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Combination of oral symptoms. "Dry mouth"= question 2a; "swollen glands"= question 2b; "drink with food"= question 2c.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cho P., Yap M. Schirmer test. II. A clinical study of its repeatability. Optom Vis Sci. 1993 Feb;70(2):157–159. doi: 10.1097/00006324-199302000-00012. [DOI] [PubMed] [Google Scholar]
  2. Drosos A. A., Andonopoulos A. P., Costopoulos J. S., Papadimitriou C. S., Moutsopoulos H. M. Prevalence of primary Sjögren's syndrome in an elderly population. Br J Rheumatol. 1988 Apr;27(2):123–127. doi: 10.1093/rheumatology/27.2.123. [DOI] [PubMed] [Google Scholar]
  3. Harley J. B., Alexander E. L., Bias W. B., Fox O. F., Provost T. T., Reichlin M., Yamagata H., Arnett F. C. Anti-Ro (SS-A) and anti-La (SS-B) in patients with Sjögren's syndrome. Arthritis Rheum. 1986 Feb;29(2):196–206. doi: 10.1002/art.1780290207. [DOI] [PubMed] [Google Scholar]
  4. Jacobsson L., Hansen B. U., Manthorpe R., Hardgrave K., Neas B., Harley J. B. Association of dry eyes and dry mouth with anti-Ro/SS-A and anti-La/SS-B autoantibodies in normal adults. Arthritis Rheum. 1992 Dec;35(12):1492–1501. doi: 10.1002/art.1780351213. [DOI] [PubMed] [Google Scholar]
  5. Montecucco C., Bestagno M., Cerino A., Caporali R., Carnevale R., Longhi M., Pedrini M. A., Astaldi-Ricotti G. C. Anti-SSB/La antibodies in Sjögren's syndrome and related autoimmune diseases. Results of a quantitative immunoassay using a highly purified antigen. Clin Exp Rheumatol. 1989 Jan-Feb;7(1):5–11. [PubMed] [Google Scholar]
  6. Paschides C. A., Kitsios G., Karakostas K. X., Psillas C., Moutsopoulos H. M. Evaluation of tear break-up time, Schirmer's-I test and rose bengal staining as confirmatory tests for keratoconjunctivitis sicca. Clin Exp Rheumatol. 1989 Mar-Apr;7(2):155–157. [PubMed] [Google Scholar]
  7. Venables P. J., Shattles W., Pease C. T., Ellis J. E., Charles P. J., Maini R. N. Anti-La (SS-B): a diagnostic criterion for Sjögren's syndrome? Clin Exp Rheumatol. 1989 Mar-Apr;7(2):181–184. [PubMed] [Google Scholar]
  8. Vitali C., Bombardieri S., Moutsopoulos H. M., Balestrieri G., Bencivelli W., Bernstein R. M., Bjerrum K. B., Braga S., Coll J., de Vita S. Preliminary criteria for the classification of Sjögren's syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum. 1993 Mar;36(3):340–347. doi: 10.1002/art.1780360309. [DOI] [PubMed] [Google Scholar]
  9. Vitali C., Bombardieri S., Moutsopoulos H. M., Coll J., Gerli R., Hatron P. Y., Kater L., Konttinen Y. T., Manthorpe R., Meyer O. Assessment of the European classification criteria for Sjögren's syndrome in a series of clinically defined cases: results of a prospective multicentre study. The European Study Group on Diagnostic Criteria for Sjögren's Syndrome. Ann Rheum Dis. 1996 Feb;55(2):116–121. doi: 10.1136/ard.55.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Vitali C., Moutsopoulos H. M., Bombardieri S. The European Community Study Group on diagnostic criteria for Sjögren's syndrome. Sensitivity and specificity of tests for ocular and oral involvement in Sjögren's syndrome. Ann Rheum Dis. 1994 Oct;53(10):637–647. doi: 10.1136/ard.53.10.637. [DOI] [PMC free article] [PubMed] [Google Scholar]

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