Focal sialadenitis in patients with ankylosing spondylitis and spondyloarthropathy: a comparison with patients with rheumatoid arthritis or mixed connective tissue disease

Objectives-To investigate the occurrence of and risk factors for focal sial adenitis in patients with rheumatoid arthritis (RA), mixed connective tissu e disease (MCTD), ankylosing spondylitis (AS), and spondyloarthropathy (SpA ). Methods-A total of 85 patients (25 with RA, 19 with MCTD, 19 with AS, 22 wi th SpA) participated in the study. Each patient filled out a questionnaire for eye and oral symptoms and for the use of medication, and was interviewe d; other tests included Schirmer's test, laboratory tests, collection of un stimulated and stimulated whole saliva, and minor salivary gland biopsy. A focus score of greater than or equal to1 was regarded as an indicator of fo cal sialadenitis. Results-Focal sialadenitis was observed in 68% (57/84) of all patients. It affected 80% (20/25) of the patients with RA, 94% (17/18) of those with MCT D, 58% (11/19) of those with AS, and 41% (9/22) of those with SpA (chi (2) test, p=0.0013). Salivary secretion correlated negatively with the focus sc ores-that is, severity of focal sialadenitis. Patients with focal sialadeni tis had both decreased salivary secretion and decreased tear secretion sign ificantly more often than did patients without (chi (2) test, p=0.0074 and p=0.048 respectively). Patients with positive rheumatoid factor (RF), antin uclear antibodies (ANA), or SSA or SSB antibodies had sialadenitis signific antly more often than did patients with negative antibodies. In the subgrou p of patients with AS or SpA, no associations were found between focal sial adenitis and the presence of these antibodies. Conclusion-In addition to patients with RA or MCTD, focal sialadenitis also affects a very high proportion of patients with AS or SpA. Focus scores ar e significantly higher in patients with RA or MCTD than in those with AS or SpA. A significant association exists between focal sialadenitis and RF, A NA, SSA and SSB. However, in the subgroup of patients with AS or SpA, no as sociations were found between focal sialadenitis and serological markers or clinical symptoms.