Adverse drug reactions in Sjogren's Syndrome - Frequent allergic reactionsand a specific trimethoprim-associated systemic reaction

Trimethoprim-associated systemic reactions, including aseptic meningitis, h ave been reported to be very rare adverse drug reactions. Patients with Sjo gren's syndrome have been overrepresented, but no epidemiological surveys o f the reaction have been conducted. To study the overall frequency of adver se drug reactions, and especially trimethoprim-associated reactions, we int erviewed 85 primary Sjogren's syndrome patients and compared the results wi th those of 45 similarly interviewed osteoarthritis patients. Antimicrobial allergy was more common among Sjogren's syndrome patients than in osteoart hritis patients (46% vs. 27%). Eleven Sjogren's syndrome patients (13%), bu t no osteoarthritis patient, had experienced at least a partial, non-allerg ic systemic reaction with trimethoprim. Of them five (6%) had had a full-bl own systemic reaction including both chills/fever and headache/backache and at least one of the following: malaise, vomiting, dizziness, confusion or meningeal irritation. Our findings confirm that allergic reactions to antimicrobials are frequent in Sjogren's syndrome. In addition to allergic reactions Sjogren's syndrom e patients are prone to a specific trimethoprim-associated systemic reactio n. This should be remembered when prescribing antimicrobials.