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We read with interest the article by Kassan and Moutsopoulos¹ about the clinical manifestations of Sjögren syndrome. We are surprised that the authors did not mention celiac disease (CD) as an association. Indeed, Iltanen et al² found that in a population of 34 patients with primary Sjögren syndrome, 5 patients (14.7%) had CD. This high prevalence has been confirmed by Szodoray et al,³ who observed a CD prevalence of 4.5% in a population of 111 patients with Sjögren syndrome, whereas the prevalence of CD is estimated to be 0.45% in the general population. This is of interest because the authors observed antimitochondrial antibodies in 7% of their patients.¹ In those cases, the histopathological appearance is similar to that of early (stage 1) primary biliary cirrhosis. We know that the prevalence of CD in patients with primary biliary cirrhosis is 10-fold higher than that in the general population.⁴ Consequently, it seems . . . [Full Text of this Article]

AUTHOR INFORMATION
Xavier Roblin, MD; Frederic Helluwaert, MD; Bruno Bonaz, MD, PhD

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Clinical Manifestations and Early Diagnosis of Sjögren Syndrome
Stuart S. Kassan and Haralampos M. Moutsopoulos
Arch Intern Med. 2004;164(12):1275-1284.
ABSTRACT | FULL TEXT