Abstract: Introduction Primary Sjögren?s syndrome (pSS) is an autoimmune disease, characterized by lymphocytic infiltration of
exocrine glands and other organs, resulting in dry eye, dry mouth and extraglandular systemic findings.
Objective To explore the association of severe or very severe dry eye with extraocular involvement in patients diagnosed
with primary Sjögren?s syndrome.
Methods SJOGRENSER registry is a multicenter cross-sectional study of pSS patients. For the construction of our main
variable, severe/very severe dry eye, we used those variables that represented a degree 3?4 of severity according to the 2007
Dry Eye Workshop classification. First, bivariate logistic regression models were used to identify the effect of each independent
variable on severe/very severe dry eye. Secondly, multivariate analysis using regression model was used to establish the
independent effect of patient characteristics.
Results Four hundred and thirty-seven patients were included in SJOGRENSER registry; 94% of the patients complained
of dry eye and 16% developed corneal ulcer. Schirmer?s test was pathological in 92% of the patients; 378 patients presented
severe/very severe dry eye. Inflammatory articular involvement was significantly more frequent in patients with severe/very
severe dry eye than in those without severe/very severe dry eye (82.5 vs 69.5%, p = 0,028). Inflammatory joint involvement
was associated with severe/very severe dry eye in the multivariate analysis, OR 2.079 (95% CI 1.096?3.941).
Conclusion Severe or very severe dry eye is associated with the presence of inflammatory joint involvement in patients with
pSS. These results suggest that a directed anamnesis including systemic comorbidities, such as the presence of inflammatory
joint involvement or dry mouth in patients with dry eye, would be useful to suspect a pSS.
