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Fatigue in primary Sjögren's syndrome
P J Barendregt1, M R Visser, E M Smets
1Department of Rheumatology, Zuiderziekenhuis, Rotterdam, The Netherlands.
Annals of the Rheumatic Diseases
|September 19, 1998
Summary
Patients with primary Sjögren's syndrome experience significant fatigue, particularly general, physical, and reduced activity dimensions, even after accounting for depression. Autonomic nervous system involvement is suggested by correlations between noradrenaline and fatigue.
Area of Science:
- Rheumatology
- Psychiatry
- Endocrinology
Background:
- Primary Sjögren's syndrome (SS) is a chronic autoimmune disease often associated with debilitating fatigue.
- Fatigue significantly impacts the quality of life for patients with SS, but its underlying mechanisms, particularly in relation to psychological and physiological factors, require further elucidation.
Purpose of the Study:
- To investigate the relationship between fatigue, depression, blood pressure, and plasma catecholamines in primary SS patients.
- To compare fatigue levels in primary SS patients with those in rheumatoid arthritis (RA) patients and healthy controls.
Main Methods:
- Utilized the Multidimensional Fatigue Inventory (MFI) and Zung depression scale to assess fatigue and depression.
- Measured blood pressure and plasma catecholamines (noradrenaline) in primary SS patients.
- Included 49 female primary SS patients, 44 female RA patients, and 32 healthy women.
Main Results:
- Primary SS patients reported higher fatigue across all MFI dimensions compared to healthy controls.
- After controlling for depression, significant differences in general fatigue, physical fatigue, and reduced activity remained between primary SS patients and controls.
- A negative correlation was observed between general fatigue and plasma noradrenaline in primary SS patients, suggesting autonomic nervous system involvement.
Conclusions:
- Fatigue in primary SS is multifactorial, with components beyond depression.
- The autonomic nervous system, specifically noradrenaline levels, may play a role in the chronic fatigue experienced by primary SS patients.
- Further research into the neuroendocrine-immune interactions in SS-related fatigue is warranted.