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Type: Journal article
Title: Increased severity of lower urinary tract symptoms and daytime somnolence in primary Sjögren's syndrome
Other Titles: Increased severity of lower urinary tract symptoms and daytime somnolence in primary Sjogren's syndrome
Author: Walker, J.
Gordon, T.
Lester, S.
Downie-Doyle, S.
McEvoy, R.
Pile, K.
Waterman, S.
Rischmueller, M.
Citation: Journal of Rheumatology, 2003; 30(11):2406-2412
Publisher: J Rheumatol Publ Co
Issue Date: 2003
ISSN: 0315-162X
Statement of
Jennifer Walker, Tom Gordon,Sue Lester, Sarah Downie-Doyle, Doug McEvoy, Kevin Pile, Sally Waterman and Maureen Rischmueller
Abstract: OBJECTIVE: Functional antimuscarinic receptor autoantibodies have recently been described in both primary and secondary Sjögren's syndrome (SS) in a mouse bladder contraction assay. Most patients with these antibodies complained of severe lower urinary tract disturbances, which are not a recognized feature of SS. We compared the severity of self-reported urological symptoms, daytime somnolence, and fatigue between a cohort of patients with primary SS and controls with osteoarthritis (OA). METHODS: Female patients were recruited from rheumatology outpatient clinics at 2 hospitals. The American Urological Symptom Index (AUA-7), Epworth Sleepiness Scale, and FACIT-F fatigue self-administered instruments were employed. Results were obtained for 76 patients with primary SS and 43 controls (response rates 85% and 67%, respectively). The patient groups were matched for parity, hormone replacement and diuretic therapy, and number of bladder operations and urinary tract infections, although OA patients were slightly older. RESULTS: AUA-7 urological symptoms were more severe in patients with primary SS compared to OA controls (p = 0.039). Severe urological symptoms were reported by 61% of primary SS patients compared with 40% of OA controls. This difference was predominantly attributable to bladder irritability associated with urgency (p = 0.015) and not nocturia (p = 0.85). Epworth Sleepiness Scale scores were also more severe in primary SS patients compared to OA controls (p = 0.02), independent of nocturia. The FACIT-F fatigue severity scores were not significantly different between patient groups (p = 0.14). CONCLUSION: Urological symptoms and daytime somnolence may be previously unrecognized symptoms of primary SS. These symptoms are consistent with functional disturbances of muscarinic receptors, possibly mediated by muscarinic receptor autoantibodies.
Keywords: Humans
Sjogren's Syndrome
Urologic Diseases
Antibodies, Antinuclear
Rheumatoid Factor
Severity of Illness Index
Case-Control Studies
Cohort Studies
Sleep Stages
Circadian Rhythm
Aged, 80 and over
Middle Aged
Rights: Copyright © 2003 The Journal of Rheumatology
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