Background/Purpose: Allergic disorders are occasionally seen in patients with primary Sjögren’s syndrome (pSS) [1]. Risk factors are unclear for allergic disorders.

We aimed to compare the prevalence of allergic disorders in pSS and rheumatoid arthritis (RA) ,and to compare the clinical features at diagnosis of pSS with and without drug allergies.

Methods: We retrospectively examined consecutive patients diagnosed with pSS or RA in our hospital from 2010 to 2020. The patients with SS met the criteria of the 1999 revised Japanese Ministry of Health criteria [2]. We included patients with pSS without RA or other rheumatic diseases. The patients with RA met the EULAR/ACR 2010 criteria. We included patients with RA without other rheumatic diseases.

The first analysis was performed on five types of allergic reactions: (1) food allergy (exanthema, angioedema and anaphylaxis after foods exposure), (2) drug allergy (exanthema, angioedema and anaphylaxis after drug exposure), (3) allergic contact dermatitis such as metals, alcohol swab, and other cosmetics, (4) seasonal allergic rhinitis and/or allergic conjunctivitis, and allergic rhinitis and/or allergic conjunctivitis associated with house dust, and (5) asthma.

The secondary analysis was performed on patient baseline laboratory data at diagnosis of pSS and RA patients with or without drug allergies.

Results: In the first analysis, 292 patients with pSS and 413 patients with RA were enrolled (Table 1). The mean ages (pSS, RA) were 57.3±15.8, 66.0±14.6 years old. Females were 94.2% , 78.2%. The mean observation period was 82.7±70.8, 65.6±37.0 months. 54.8% of pSS patients and 34.9% of RA patients presented at least one type of allergic disorders or drug allergies. These included food allergy, drug allergy, allergic rhinitis/conjunctivitis, and asthma. Allergic disorders and drug allergies were more frequent in patients with pSS.

In the second analysis, 77 patients with drug allergies and 215 patients without drug allergies were enrolled (Table 2). The mean ages with drug allergies and without drug allergies were 56.0±15.8 and 57.8±15.8 years old, respectively; females were 96.1% and 93.5%; the mean observation period was 90.9±72.4 and 79.8±70.2 months (Table 2). The pSS patients with drug allergies had higher levels of Immunoglobulin G (IgG) (p = 0.01), higher levels of eosinophils (p< 0.019), and higher positivity rate of anti–Sjögren's-syndrome-related antigen A autoantibody (anti-SSA antibody) than those without drug allergies (p = 0.06) (Table 2).

Conclusion: Patients with pSS had a higher prevalence of allergic disorders and drug allergies than patients with RA. Among patients with pSS, patients with drug allergies had higher levels of IgG, higher levels of eosinophils, and higher positivity rate of anti-SSA antibody than those without drug allergies.

[1] Hama et al. Clinical features of patients with Sjoegren syndrome associated with adult onset Still’s disease. Japan College of Rheumatology Annual Congress 2020.
[2] Fujibayashi et al. Revised Japanese criteria for Sjögren’s syndrome (1999): availability and validity. Mod Rheumatol. 2004; 14: 425-34 .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/allergic-disorders-in-primary-sjogrens-syndrome-compared-with-rheumatoid-arthritis/