Both Sjögren's syndrome (SS) and non-Sjögren's syndrome (NSS) can present with the sicca symptoms of dry eyes and a dry mouth but they are distinct pathological entities that require diagnostic discrimination. This study included 82 sicca syndrome patients and examined the ability of sialoscintigraphy and antibodies against the autoantigens α-fodrin, Ro and La to discriminate between SS and NSS. A total of 30.8% of SS patients compared with 58.8% of NSS patients were α-fodrin positive. The prevalence of Ro positivity was 69.4% for SS patients compared with 0% for NSS patients. The prevalence of La positivity was 52.4% for SS compared with 0% for NSS patients. Sialoscintigraphy showed that more NSS patients had grade III salivary gland impairment compared with SS patients (64.7% versus 19.4%). These data suggest that using sialoscintigraphy in combination with measuring the levels of serum α-fodrin, Ro and La might be useful for SS and NSS discrimination.
MasakiYSugaiS: Lymphoproliferative disorders in Sjögren's syndrome. Autoimmun Rev2004; 3: 175–182.
3.
MahoneyEJSpiegelJH: Sjögren's disease. Otolaryngol Clin N Am2003; 36: 733–745.
4.
VitaliCBombardieriSJonssonR: Classification criteria for Sjögren's syndrome: A revised version of the European criteria proposed by the American–European consensus group. Ann Rheum Dis2002; 61: 554–558.
5.
SalliotCMouthonLArdizzoneM: Sjögren's syndrome is associated with and not secondary to systemic sclerosis. Rheumatology (Oxford)2007; 46: 321–326.
6.
ScofieldRHAsfaSObesoD: Immunization with short peptides from the 60-kDa Ro antigen recapitulates the serological and pathological findings as well as the salivary gland dysfunction of Sjögren's syndrome. J Immunol2005; 175: 8409–8414.
7.
BolstadAIWassmuthRHagaHJ: HLA markers and clinical characteristics in Caucasians with primary Sjögren's syndrome. J Rheumatol2001; 28: 1554–1562.
8.
HayEMThomasEPalB: Weak association between subjective symptoms of and objective testing for dry eyes and dry mouth: Results from a population based study. Ann Rheum Dis1998; 57: 20–24.
9.
MaruyamaTSaitoIHayashiY: Molecular analysis of the human autoantibody response to α-fodrin in Sjögren's syndrome reveals novel apoptosis-induced specificity. Am J Pathol2004; 165: 53–61.
10.
HanejiNNakamuraTTakioK: Identification of α-fodrin as a candidate autoantigen in primary Sjögren's syndrome. Science1997; 276: 604–607.
11.
WillekePGaubitzMSchotteH: Clinical and immunological characteristics of patients with Sjögren's syndrome in relation to α-fodrin antibodies. Rheumatology (Oxford)2007; 46: 479–483.
12.
WitteT: Anti-α-fodrin antibodies in Sjögren's syndrome: A review. Ann NY Acad Sci2005; 1051: 235–239.
13.
RuffattiAOstuniPGrypiotisP: Sensitivity and specificity for primary Sjögren's syndrome of IgA and IgG anti-α-fodrin antibodies detected by ELISA. J Rheumatol2004; 31: 504–507.
14.
ZandbeltMMVogelzangsJVan De PutteLB: Anti-α-fodrin antibodies do not add much to the diagnosis of Sjögren's syndrome. Arthritis Res Ther2004; 6: R33–R38.
15.
ChampeyJCorrubleEGottenbergJE: Quality of life and psychological status in patients with primary Sjögren's syndrome and sicca symptoms without autoimmune features. Arthritis Rheum2006; 55: 451–457.
16.
RosenquistR: Introduction: The role of inflammation, autoimmune disease and infectious agents in development of leukaemia and lymphoma. J Intern Med2008; 264: 512–513.
17.
SmedbyKEAsklingJMarietteX: Autoimmune and inflammatory disorders and risk of malignant lymphomas–an update. J Intern Med2008; 264: 514–527.
18.
ArnettFCEdworthySMBlochDA: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum1988; 31: 315–324.
19.
AungWMurataYIshidaR: Study of quantitative oral radioactivity in salivary gland scintigraphy and determination of the clinical stage of Sjögren's syndrome. J Nucl Med2001; 42: 38–43.
20.
NishiyamaSMiyawakiSYoshinagaY: A study to standardize quantitative evaluation of parotid gland scintigraphy in patients with Sjögren's syndrome. J Rheumatol2006; 33: 2470–2474.
21.
FoxRI: Sjögren's syndrome: Current therapies remain inadequate for a common disease. Expert Opin Investig Drugs2000; 9: 2007–2016.
22.
van WoerkomJMKruizeAAWijkMJ Wenting-van: Salivary gland and peripheral blood T helper 1 and 2 cell activity in Sjögren's syndrome compared with non-Sjögren's sicca syndrome. Ann Rheum Dis2005; 64: 1474–1479.
23.
LangermanAJBlairEASweissNJ: Utility of lip biopsy in the diagnosis and treatment of Sjogren's syndrome. Laryngoscope2007; 117: 1004–1008.
24.
LochtHPelckRManthorpeR: Diagnostic and prognostic significance of measuring antibodies to α-fodrin compared to anti-Ro-52, anti-Ro-60, and anti-La in primary Sjögren's syndrome. J Rheumatol2008; 35: 845–849.
25.
MaenoNTakeiSImanakaH: Anti-α-fodrin antibodies in Sjögreńs syndrome in children. J Rheumatol2001; 28: 860–864.
26.
JonssonRHagaH-JGordonR: Sjögren's syndrome. In: Arthritis and Allied Conditions–a Textbook of Rheumatology, 14th edn (KoopmanWJMorelandLW, eds). Philadelphia: Lippincott Williams & Wilkins, 2001; pp 1736–1759.
27.
GrusFHJoachimSCBrunsK: Serum autoantibodies to α-fodrin are present in glaucoma patients from Germany and the United States. Invest Ophthalmol Vis Sci2006; 47: 968–976.
28.
KahalyGJBangHBergW: α-Fodrin as a putative autoantigen in Graves’ ophthalmopathy. Clin Exp Immunol2005; 140: 166–172.
29.
LisiSSistoMSoletiR: Fcγ receptors mediate internalization of anti-Ro and anti-La autoantibodies from Sjögren's syndrome and apoptosis in human salivary gland cell line A-253. J Oral Pathol Med2007; 36: 511–523.
