Rheumatology Advance Access originally published online on April 14, 2008
Rheumatology 2008 47(6):914-919; doi:10.1093/rheumatology/ken107
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Autonomic nervous symptoms in primary Sjögren's; syndrome
1Department of Rheumatology, 2Department of Endocrinology, 3Department of Clinical Physiology, Malmö University Hospital and 4Sjögren's Syndrome Research Centre, Malmö, Sweden.
Correspondence to: T. Mandl, Department of Rheumatology, Ing 25 plan 2, Malmö University Hospital, S-205 02 Malmö, Sweden. E-mail: thomas.mandl{at}med.lu.se
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Abstract |
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Objectives. Objective signs of autonomic dysfunction (AD) have been reported in patients with primary SS (pSS) while the presence of associated symptoms has not been systematically studied. Therefore, the aims of this study were (i) to assess the presence and severity of various AD symptoms in pSS patients and (ii) to relate AD symptoms to other clinical features of pSS.
Methods. Thirty-eight pSS patients and 200 population-based controls were studied for presence and severity of AD symptoms using the Autonomic Symptom Profile (ASP), a validated self-completed questionnaire evaluating various AD symptoms. In addition, patients were investigated by three different objective autonomic nervous function tests.
Results. pSS patients scored significantly higher in the parasympathetic [secretomotor disorder, urinary disorder, gastroparesis (females only) and pupillomotor disorder] as well as sympathetic (orthostatic intolerance and vasomotor disorder) ASP domains compared with controls. Consequently, the standardized ASP total score was significantly increased in pSS patients [1.77 (0.57, 3.15) vs – 0.21 (–0.82, 0.72); P = 0.00] and 45% of pSS patients had an ASP total score 
2 S.D. Furthermore, the autonomic nervous function tests showed signs of objective parasympathetic and sympathetic dysfunction as well. However, the ASP domain and total scores showed limited associations with the objective autonomic nervous function test parameters as well as clinical and serological factors of pSS.
Conclusions. pSS patients showed subjective and objective signs of both a parasympathetic and a sympathetic dysfunction. However, AD symptoms showed limited associations with objective autonomic nervous function as well as other clinical features of the disease.
KEY WORDS: Autonomic symptoms, Primary Sjögren's; syndrome, Cardiovascular, Nervous, Physiology
Submitted 21 November 2007;
revised version accepted 13 February 2008.
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