157
LETTERS TO THE EDITOR tWestminster Hospital, Dean Ryle Street, London WC1 tHoechst-Aktiengesellschaft, D-6200 Wiesbaden 12, W. Germany ^Staffordshire Rheumatology Centre, Stoke-on-Trent Received 20 December 1989 Sjogren's Syndrome and Diabetes Mellitus SIR—I would like to comment on the paper by Binder et al. [1] on the increased prevalence of primary Sjogren's syndrome (SS) in patients with insulin dependent diabetes mellitus (IDDM). Both primary SS and IDDM share the same autoimmune HLA haplotype, i.e. A1B8DR3, therefore it is not unreasonable to postulate that the two can occur together in the same patient more often than by chance. Indeed, on this assumption I screened a total of 100 DM patients and 63 control subjects for the presence of SS while working on my thesis [2]. My observations were much different to those reported by Binder et al. (Table I). The frequency of dry eyes in RA patients was as expected. In the IDDM patients both dry eyes and mouth were less common than even in the control group. In noninsulin dependent diabetics (NIDDM), although Shirmer's test (ST) was abnormal in over a third, keratoconjunctivitis sicca (KCS) on more objective tests (rose
TABLE I RESULTS OF SCREENING OF DIABETICS, RA PATIENTS AND CONTROLS (OSTEOARTHRITIS/SPONDYLOSIS) FOR PRESENCE OF SICCA SYMPTOMS AND SIGNS
Diabetics
RA patients
Characteristics
IDDM
NIDDM
Number Male/female Mean age±SD, years (Range) Mean duration±SD, years (Range) Admits to dry or gritty eyes (%) Admits to dry mouth (%)
43 15/28 44±17 (18-82)
33 4/29 56±7 (20-75) 11.6+8.5 (1-30) 8(24.3) 5(15)
63 26/37 43 ±16 (18-74)
Abnormal Schirmer's test* (%)
6(13.9)
17(51.5) (P=0.01) 11 (33.3)
11 (17.5)
0
57 30/27 65+9 (37-85) 7.4±6.5 (1-26) 14 (24.6) 10(17.5) (P=0.05) 22 (38.6) (P
LETTERS TO THE EDITOR tWestminster Hospital, Dean Ryle Street, London WC1 tHoechst-Aktiengesellschaft, D-6200 Wiesbaden 12, W. Germany ^Staffordshire Rheumatology Centre, Stoke-on-Trent Received 20 December 1989 Sjogren's Syndrome and Diabetes Mellitus SIR—I would like to comment on the paper by Binder et al. [1] on the increased prevalence of primary Sjogren's syndrome (SS) in patients with insulin dependent diabetes mellitus (IDDM). Both primary SS and IDDM share the same autoimmune HLA haplotype, i.e. A1B8DR3, therefore it is not unreasonable to postulate that the two can occur together in the same patient more often than by chance. Indeed, on this assumption I screened a total of 100 DM patients and 63 control subjects for the presence of SS while working on my thesis [2]. My observations were much different to those reported by Binder et al. (Table I). The frequency of dry eyes in RA patients was as expected. In the IDDM patients both dry eyes and mouth were less common than even in the control group. In noninsulin dependent diabetics (NIDDM), although Shirmer's test (ST) was abnormal in over a third, keratoconjunctivitis sicca (KCS) on more objective tests (rose
TABLE I RESULTS OF SCREENING OF DIABETICS, RA PATIENTS AND CONTROLS (OSTEOARTHRITIS/SPONDYLOSIS) FOR PRESENCE OF SICCA SYMPTOMS AND SIGNS
Diabetics
RA patients
Characteristics
IDDM
NIDDM
Number Male/female Mean age±SD, years (Range) Mean duration±SD, years (Range) Admits to dry or gritty eyes (%) Admits to dry mouth (%)
43 15/28 44±17 (18-82)
33 4/29 56±7 (20-75) 11.6+8.5 (1-30) 8(24.3) 5(15)
63 26/37 43 ±16 (18-74)
Abnormal Schirmer's test* (%)
6(13.9)
17(51.5) (P=0.01) 11 (33.3)
11 (17.5)
0
57 30/27 65+9 (37-85) 7.4±6.5 (1-26) 14 (24.6) 10(17.5) (P=0.05) 22 (38.6) (P
