Autonomic cardiovascular neuropathy in Sjogren's syndrome. A controlled study

Objective. To test patients with primary Sjogren's syndrome (SS) for eviden ce of autonomic neuropathy, Methods, Thirty-two patients with primary SS and 22 age and sex matched hea lthy individuals were asked specific questions about symptoms suggestive of autonomic neuropathy, and were subjected to a battery of 5 cardiovascular tests: response of blood pressure to sustained hand grip, Valsalva maneuver , heart rate response to deep breathing, and heart rate and blood pressure response to standing up. The chi-squared test with Yates' correction and 95 % confidence intervals were used for statistical analysis of the results, Results, Sixteen patients (50%) had symptoms of autonomic neuropathy when s pecifically asked versus none of the controls (p < 0.0005). The frequency o f abnormal responses to the tests was 68.8% in patients and 12.7% in contro ls (p < 0.0001). Severe autonomic cardiovascular neuropathy was found in 87 .5% of the patients but in none of the healthy individuals (p < 0.0001), Conclusion. Our results suggest that autonomic neuropathy is a feature of a significant portion of the SS population, and such patients should have ap propriate evaluation. Similarly, patients with unexplained autonomic neurop athy should be investigated for evidence of SS.