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Cytopenia associated with ocular damage in patients with primary Sjögren’s syndrome

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Research presented at the European League Against Rheumatism Annual European Congress of Rheumatology demonstrated an association between autoimmune cytopenia and ocular surface damage in patients with primary Sjögren’s syndrome.

Researchers analyzed data from 113 patients with Sjögren’s syndrome (pSS) enrolled in the Korean Initiative of primary Sjögren’s syndrome (KISS) study. All patients included in the study met the European League Against Rheumatism (EULAR) criteria for pSS. Disease activity was measured using the EULAR Sjögren’s syndrome disease activity index (ESSDAI), which includes information about extraglandular manifestations (EGMs) found in pSS. Xerophthalmia was assessed with the Ocular Surface Disease Index, Schirmer I test, ocular stain score (OSS) and tear film breakup time.

The mean ESSDAI score was 2, and approximately 25% of patients did not have systemic involvement. Autoimmune cytopenia was present in 27 patients (23.9%), and moderate biological features were seen in 37% of patients with cytopenia compared with 12.8% of patients without autoimmune cytopenia.

One patient with autoimmune cytopenia had evidence of articular involvement, which was seen in 22 patients without autoimmune cytopenia. Using Sicca’s or van Bijsterveld’s scoring system, higher OSS and lower mean Schirmer I test scores were observed in patients with autoimmune cytopenia but not in patients without autoimmune cytopenia. Both scoring methods showed a correlation with leucocyte counts, OSS and tear film breakup time, according to the researchers.

“Autoimmune cytopenia is closely associated with severe ocular surface damage in pSS,” the researchers wrote. “Therefore, assessment of xerophthalmia by ophthalmologists may be mandatory, particularly in pSS patients with cytopenia, even if patients do not complain of eye dryness.” – by Shirley Pulawski

Reference:

Koh JH, et al. Paper #AB0579. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.