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Rheumatology 2002; 41: 416-422
© 2002 British Society for Rheumatology

Original Papers

Dry eyes and mouth syndrome—a subgroup of patients presenting with sicca symptoms

E. J. Price and P. J. W. Venables1,

Department of Rheumatology, Princess Margaret Hospital, Okus Road, Swindon SN1 4JU and
1 Kennedy Institute of Rheumatology Division, Imperial College, 1 Aspenlea Road, London W6 8LH, UK

Objective. To evaluate the characteristics of patients presenting with symptoms suggestive of Sjögren's syndrome (SS) but failing to satisfy diagnostic criteria.

Methods. Clinical, serological and histological data were collected on 34 patients presenting with dry eyes and/or mouth who did not satisfy the Vitali criteria for the diagnosis of SS. They were compared with 136 patients with primary SS, 38 patients with secondary SS, and 13 patients without SS. Questionnaires on symptoms from each group were compared with 43 healthy controls.

Results. The 34 patients who did not satisfy the diagnostic criteria for SS or any other connective tissue disease were designated dry eyes and mouth syndrome (DEMS). Their demography including age was similar to that of a primary SS group and there was no more atrophy seen on their biopsies compared with SS and non-SS controls. They scored highly on visual analogue scales of symptoms but had few objective signs. All were negative for anti-Ro and anti-La although the prevalence of antinuclear antibodies (19%) was increased compared with a normal population. There was no excess of SS-associated tissue types.

Conclusion. There was no evidence that age, salivary gland atrophy or subclinical SS accounted for the symptoms in DEMS. Most of the patients fitted into a spectrum of disease which tended more towards fibromyalgia and/or chronic fatigue syndrome.

KEY WORDS: Sicca, Dry eyes and mouth syndrome (DEMS), Sjögren's syndrome.

Correspondence to: P. J. W. Venables.


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