Clinicopathological findings consistent with primary Sjögren's syndrome in a subset of patients diagnosed with chronic fatigue syndrome: Preliminary observations

David Sirois, B. Natelson

Research output: Contribution to journalArticle

Abstract

Objective. Some patients diagnosed with chronic fatigue syndrome (CFS) have symptoms commonly observed in Sjögren's syndrome (SS), particularly xerophthalmia and xerostomia, leading to speculation that some patients with CFS might have primary SS or that the 2 disorders share common pathophysiological features. We investigated the prevalence of symptoms of mucosal dryness, salivary gland pathology, lacrimal hyposecretion, and autoantibodies (antinuclear antibody, SSA/SSB) among patients diagnosed with CFS. Methods. Twenty-five subjects with CFS and 18 healthy control subjects were interviewed and examined, had a Schirmer test and fluorescein tear dilution, and underwent minor salivary gland (MSG) biopsy. Antibody to nuclear antigen as well as anti-La (SSA) and anti-Ro (SSB) antibody were available for subjects with CFS. Pathologists unaware of the subject group assignment examined labial salivary gland biopsy specimens and calculated a standard MSG score for each specimen. Results. Mucosal dryness was reported by 13/25 (52%) subjects with CFS, of which 8 (32%) also had MSG score, low Schirmer test value, and symptoms consistent with primary SS (p = 0.05). No control subject met diagnostic criteria for primary SS. MSG focus scores ≤ 1 were common among both groups (CFS 14/25; controls 15/18). MSG results without pathological alteration were rare, seen in only one control and no CFS patients. Low Schirmer values were found in 10/25 (40%) CFS patients and 1/18 (6%) control (p = 0.01). Conclusion. A subset of patients with CFS may have primary SS.

Original languageEnglish (US)
Pages (from-to)126-131
Number of pages6
JournalJournal of Rheumatology
Volume28
Issue number1
StatePublished - 2001

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Chronic Fatigue Syndrome
Minor Salivary Glands
Salivary Glands
Tears
Xerophthalmia
Biopsy
Xerostomia
Nuclear Antigens
Antinuclear Antibodies
Lip
Fluorescein
Autoantibodies
Healthy Volunteers
Pathology

Keywords

  • Chronic fatigue syndrome
  • Diagnosis
  • Sjögren's syndrome

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

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title = "Clinicopathological findings consistent with primary Sj{\"o}gren's syndrome in a subset of patients diagnosed with chronic fatigue syndrome: Preliminary observations",
abstract = "Objective. Some patients diagnosed with chronic fatigue syndrome (CFS) have symptoms commonly observed in Sj{\"o}gren's syndrome (SS), particularly xerophthalmia and xerostomia, leading to speculation that some patients with CFS might have primary SS or that the 2 disorders share common pathophysiological features. We investigated the prevalence of symptoms of mucosal dryness, salivary gland pathology, lacrimal hyposecretion, and autoantibodies (antinuclear antibody, SSA/SSB) among patients diagnosed with CFS. Methods. Twenty-five subjects with CFS and 18 healthy control subjects were interviewed and examined, had a Schirmer test and fluorescein tear dilution, and underwent minor salivary gland (MSG) biopsy. Antibody to nuclear antigen as well as anti-La (SSA) and anti-Ro (SSB) antibody were available for subjects with CFS. Pathologists unaware of the subject group assignment examined labial salivary gland biopsy specimens and calculated a standard MSG score for each specimen. Results. Mucosal dryness was reported by 13/25 (52{\%}) subjects with CFS, of which 8 (32{\%}) also had MSG score, low Schirmer test value, and symptoms consistent with primary SS (p = 0.05). No control subject met diagnostic criteria for primary SS. MSG focus scores ≤ 1 were common among both groups (CFS 14/25; controls 15/18). MSG results without pathological alteration were rare, seen in only one control and no CFS patients. Low Schirmer values were found in 10/25 (40{\%}) CFS patients and 1/18 (6{\%}) control (p = 0.01). Conclusion. A subset of patients with CFS may have primary SS.",
keywords = "Chronic fatigue syndrome, Diagnosis, Sj{\"o}gren's syndrome",
author = "David Sirois and B. Natelson",
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volume = "28",
pages = "126--131",
journal = "Journal of Rheumatology",
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T1 - Clinicopathological findings consistent with primary Sjögren's syndrome in a subset of patients diagnosed with chronic fatigue syndrome

T2 - Preliminary observations

AU - Sirois, David

AU - Natelson, B.

PY - 2001

Y1 - 2001

N2 - Objective. Some patients diagnosed with chronic fatigue syndrome (CFS) have symptoms commonly observed in Sjögren's syndrome (SS), particularly xerophthalmia and xerostomia, leading to speculation that some patients with CFS might have primary SS or that the 2 disorders share common pathophysiological features. We investigated the prevalence of symptoms of mucosal dryness, salivary gland pathology, lacrimal hyposecretion, and autoantibodies (antinuclear antibody, SSA/SSB) among patients diagnosed with CFS. Methods. Twenty-five subjects with CFS and 18 healthy control subjects were interviewed and examined, had a Schirmer test and fluorescein tear dilution, and underwent minor salivary gland (MSG) biopsy. Antibody to nuclear antigen as well as anti-La (SSA) and anti-Ro (SSB) antibody were available for subjects with CFS. Pathologists unaware of the subject group assignment examined labial salivary gland biopsy specimens and calculated a standard MSG score for each specimen. Results. Mucosal dryness was reported by 13/25 (52%) subjects with CFS, of which 8 (32%) also had MSG score, low Schirmer test value, and symptoms consistent with primary SS (p = 0.05). No control subject met diagnostic criteria for primary SS. MSG focus scores ≤ 1 were common among both groups (CFS 14/25; controls 15/18). MSG results without pathological alteration were rare, seen in only one control and no CFS patients. Low Schirmer values were found in 10/25 (40%) CFS patients and 1/18 (6%) control (p = 0.01). Conclusion. A subset of patients with CFS may have primary SS.

AB - Objective. Some patients diagnosed with chronic fatigue syndrome (CFS) have symptoms commonly observed in Sjögren's syndrome (SS), particularly xerophthalmia and xerostomia, leading to speculation that some patients with CFS might have primary SS or that the 2 disorders share common pathophysiological features. We investigated the prevalence of symptoms of mucosal dryness, salivary gland pathology, lacrimal hyposecretion, and autoantibodies (antinuclear antibody, SSA/SSB) among patients diagnosed with CFS. Methods. Twenty-five subjects with CFS and 18 healthy control subjects were interviewed and examined, had a Schirmer test and fluorescein tear dilution, and underwent minor salivary gland (MSG) biopsy. Antibody to nuclear antigen as well as anti-La (SSA) and anti-Ro (SSB) antibody were available for subjects with CFS. Pathologists unaware of the subject group assignment examined labial salivary gland biopsy specimens and calculated a standard MSG score for each specimen. Results. Mucosal dryness was reported by 13/25 (52%) subjects with CFS, of which 8 (32%) also had MSG score, low Schirmer test value, and symptoms consistent with primary SS (p = 0.05). No control subject met diagnostic criteria for primary SS. MSG focus scores ≤ 1 were common among both groups (CFS 14/25; controls 15/18). MSG results without pathological alteration were rare, seen in only one control and no CFS patients. Low Schirmer values were found in 10/25 (40%) CFS patients and 1/18 (6%) control (p = 0.01). Conclusion. A subset of patients with CFS may have primary SS.

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