Heberden Oration : A Broader Spectrum of Sjogren's Syndrome and Its Pathogenetic Implications

Abstract

The studies reported here have broadened the spectrum of Sjogren''s syndrome and have given additional support to Sjogren''s original impression that the disease is systemic. The association of this syndrome with rheumatoid arthritis seems significant, although the basis for this linkage remains unexplained. Several features which rheumatoid arthritis alone alone shares with Sjogren''s syndrome not associated with rheumatoid arthritis, such as vasculitis, neuropathy, and hyperglobulinemia, are interesting, The high incidence of rheumatoid factor in this syndrome, even in the absence of rheumatoid arthritis, is intriguing. The unusual concurrence of Hashimoto''s thyroiditis and Sjogren''s syndrome (especially in view of a similar histopathological response in both conditions) and the frequent occurrence of thyroglobulin antibodies in the patients of this series require further investigation. The pathogenic implications of the high frequency of circulating antibodies to tissue components in this syndrome, as in certain other chronic diseases, are provocative but remain as yet obscure.