The British Journal of Rheumatology, Vol 36, 1312-1317, Copyright © 1997 by British Society for Rheumatology
DG Kassimos, PJ Shirlaw, EH Choy, K Hockey, PR Morgan, SJ Challacombe and GS Panayi
Amongst the patients attending our combined oral medicine/rheumatology
clinic, we have identified a subset presenting with xerostomia due to
non-specific sialadenitis, who also suffer from generalized nodal
osteoarthritis (NOA). We have called this combination SOX syndrome:
sialadenitis, osteoarthritis and xerostomia. In this study, we have
examined the characteristics of these patients clinically and
histologically, and then determined the prevalence of SOX syndrome in
patients with NOA compared to healthy age-matched controls. Patients were
obtained from rheumatology clinics and a local old people's home. The
series consisted of 35 patients with NOA and 18 age- and sex- matched
controls without evidence of NOA or inflammatory rheumatic disease. There
was no significant difference in age and sex between the two groups. None
were on drugs known to induce xerostomia. The subjects were assessed for
whole salivary, parotid saliva and lacrimal flow, autoantibodies,
rheumatoid factor (RF) and erythrocyte sedimentation rate (ESR). The whole
saliva flow (mean +/- 95% CI) was 0.32 +/- 0.07 ml/min for the NOA group
and 0.54 +/- 0.17 ml/min for the control group. The difference is
statistically significant (P < 0.05, two- tailed Student's t-test). No
statistically significant difference was found in the parotid and lacrimal
flow rates of NOA and controls. Nine of the 35 NOA patients had reduced
whole salivary flow (normal range > 0.02 ml/min) compared with only one
out of 18 in the control group (P > 0.05, chi 2 test). All NOA patients
with xerostomia and reduced whole salivary flow were RF, anti-Ro and
anti-La negative, and had a normal ESR. Thus, 25% of subjects with NOA had
clinical and laboratory features of SOX syndrome, suggesting that this is a
defined disease entity.
ORIGINAL PAPERS
Chronic sialadenitis in patients with nodal osteoarthritis
Rheumatology Unit, United Medical School, Guys Hospital, London.
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