Sympathetic dysfunction in patients with primary Sjogren's syndrome

Objective. To investigate autonomic nervous system function in patients wit h primary Sjogren's syndrome (SS) and relate the findings to clinical varia bles. Methods. Autonomic nervous system function was determined in 30 patients wi th primary SS using the finger skin blood flow test [vasoconstrictory (VAC) index], deep-breathing test [expiration/inspiration (E/I) ratio], and the tilt table (orthostatic) test [acceleration index (AI), brake index (BI), a nd orthostatic blood pressure]. The results were compared with age matched control materials (finger skin blood flow test, n = 80, and deep-breathing and tilt table tests, n = 56). Results. The VAC index was found to be significantly increased and the E/I ratio significantly decreased in patients compared to controls, indicating both a sympathetic and a parasympathetic dysfunction. Further, the patients , especially the anti-SSA and anti-SSB antibody seropositives, were found t o have an abnormal blood pressure reaction to tilt compared to controls. No correlations were found between autonomic nerve function variables measure d and the clinical ophthalmologic or the oral tests, performed at the time of diagnosis. Conclusion. Patients with primary SS show signs of both sympathetic and par asympathetic dysfunction. Further, immunological mechanisms seem to influen ce blood pressure in patients with primary SS.