DIFFERENCES IN THE CLINICAL MANIFESTATIONS OF SICCA SYNDROME IN THE PRESENCE AND ABSENCE OF RHEUMATOID-ARTHRITIS

The clinical features of patients with the sicca syndrome in the presence and absence of rheumatoid arthritis were reviewed. All patients were followed at the National Institutes of Health for at least 5 yr after the diagnosis of sicca syndrome. Patients (22) had sicca syndrome alone; 21 patients had definite rehumatoid arthritis and the sicca syndrome. Rheumatoid arthritis tended to precede the development of sicca syndrome. The mean age at diagnosis of sicca syndrome was the same in both groups. No significant differences in serum immunoglobulin, the 3rd component of complement (C3), rheumatoid factor titer and salivary histopathology were found. The clinical features were quite distinct. Patients with sicca syndrome alone had a significantly greater frequency of recurrent parotitis. Raynaud''s phenomenon, purpura, lymphadenopathy, myositis and renal involvement. The clinical characteristics of these 2 groups coupled with the known serologic and genetic differences suggested that sicca syndrome alone is a distinct pathologic entity.