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Widespread pain and Sjögren's syndrome
1National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland 20892, USA.
Objective:
Reports exist of an association between fibromyalgia (FM) and Sjogren's syndrome (SS). Widespread pain is a necessary component of FM. We explored the association of widespread pain and SS.
Methods:
Data were abstracted from the records of the most recent 100 patients evaluated in the SS clinic. The subjects included individuals with or without SS who had screened for features of the disorder. Patients with confounding disorders or missing data were excluded. The presence of widespread pain was established by questionnaire in 92 subjects. Widespread pain followed the definition in the 1990 American College of Rheumatology classification criteria for FM. By objective criteria used in the clinic, patients were initially classified into SS (requiring keratoconjunctivitis sicca. positive labial salivary gland biopsy, and serological evidence of autoimmunity), incomplete SS (at least one of the latter objective findings), or non-SS (if all 3 objective findings were negative). For subsequent analyses, the study population was also classified into cases by applying the European criteria for SS, and the subjective or objective components of European criteria. Descriptive statistics and Cochran-Mantel chi-square tests were performed.
Results:
Only 2/27 (7%) of those diagnosed with SS reported symptoms of widespread pain. The incomplete SS group consisted of 8/56 (14%), while the non-SS were 1/9 (11%). There was a trend toward greater widespread pain in those 9 of 52 (17%) subjects meeting the European criteria for SS who had widespread pain compared with 2 of 50 (5%) who did not. However, this was not significant (p = 0.0728). The greater the subjectivity of the criteria applied to classify cases of SS, the higher was the prevalence of widespread pain. No significant association was found between widespread pain and SS for any of the criteria applied.
Conclusion:
No significant association between widespread pain and SS was found in our study population. Further study is indicated to explore a possible lack of association between SS and FM.