The gastrointestinal involvement in primary Sjögren's syndrome

Gastrointestinal manifestations in patients with primary Sjögren's syndrome (SS), which is an autoimmune exocrinopathy, include dysphagia, nausea, epigastric pain, dyspepsia and nutritional deficiencies. In this report, we are presenting the nature and incidence of esophageal, pancreatic and liver involvement in our primary SS patients. Esophageal motility was studied in 27 patients with primary SS and 25 normal age and sex matched volunteers. Esophageal dysfunction was detected in 11 of the 27 patients (40.71%). Individual analysis of the esophageal motility studies showed different patterns of esophageal dysfunction. These esophageal abnormalities did not correlate with the parotid flow rate, the degree of inflammatory infiltrate of the minor salivary glands, the extraglandular manifestations or the presence of autoantibodies. Sera from 25 patients with primary SS were studied for the total serum alpha-amylase activity and isoamylases. Sera from 81 normal age and sex matched volunteers were used as controls. None of these patients had abdominal pain or gastrointestinal symptoms at the time of blood collection. The presence of hyperamylasemia of P-type and S-type in 6/25 patients (24%) probably reflects a slow, subclinical, inflammatory process of the exocrine glands. Clinical and biochemical evaluation of the liver function was studied in 22 primary SS patients. One of them had abnormal liver function tests and another hepatomegaly and splenomegaly. Percutaneous liver biopsies in both revealed chronic active hepatitis.