Abstracts 603

THE PREVALENCE AND PROGRRSSON OF SALADBNFI’IS IN RHEUMATIC PATIENTS. R Jonsson, K Biickman, U Kroneld, and A Tarkowski, University of GSteborg, Sweden maladenitis of the minor salivary glands is a major manifestation of Sjb;gren’s syndrome (SS) and this gland disorder is thought to be progressive. However, little information is available regarding the prevalence and outcome of autoimmune sialadenitis. To clarify this we evaluated rheumatic patients with histological and functional assessments of salivary glands.

Eighty-six patients with sicca complaints attending a rheumatology clinic were evaluated for rheumatic diagnosis, objective signs of sialadenitis, and stimulated production of whole saliva. In addition fourteen patients with primary SS (N=7) and secondary SS (N=7) were followed for a mean of 34 months (range 12-55 months). The diagnosis was based on oral sicca symptoms and histological signs of focal sialadenitis (focus score) in a labial salivary gland biopsy. Almost 50% (41/86) of the patients displayed a focus score >/2. Normal salivary secretion was recorded in 17% (7/41) of patients with sialadenitis while 51% (23/45) with pathological salivary secretion had no significant sialadenitis. During the follow up period the focus score increased with a mean of 1.8 (range -2 to +‘7). A mean increase in focus score could be calculated to 0.6 (range -2 to 3.5) per patient and year. Simultaneous measurement of stimulated whole salivary secretion showed a decrease with a mean of 0.04 ml/min (range +0.4 to -0.6) per patient during the observation period. In this prospective study the finding of simultaneously increased focus score and reduced salivary secretion, was note in 7/14 (50%) of the patients. Dryness of the mouth in rheumatic patients can often be explained by focal sialadenitis in labial glands. The slow decrease of salivary secretion indicates a long time lag from initial disease outbreak with sialadenitis to decreased functional capacity of salivary glands.

PSYCHIATRIC MANIFESTATIONS IN PRIMARY SJOGREN'S SYNDROME. MF Kahn, Faculte de M6decine Xavier Bichat,Universite Paris VII. Paris, (FRANCE)

As others, we were impressed by the frequent occurence of psychiatric disturbances (P.D.) in primary Sjllgren's syndrome (PSS). To confirm this, we have compared the frequency of P.D. in different connective tissue diseases. We have classified the patients on the ground of one simple criteria: have they or not consulted a psychiatrist during the last 5 years. The results were as follow:

N N.psy +%

- Systemic lupus eryth. 120 13 10.8 - Systemic sclerosis 73 4 5.4 - Dermatopolymyositis 13 - MCTD :8' 4 6.8 - RheumatoPd Arthritis* 226 - Primary SjSgren's Syndrome a7 :: 2;::*

* Differences with all the other group p <.05. In most of the cases , major anxiety was the main psychiatric symptom. We cannot assess from this study if the P.D. were linked to the P.S.S. or an associated constitutionnal feature.

MOLECULAR CHARACTERIZATION OF SSB/LA and SSA/RO ANTIGEN BY DIFFERENT ELZCTROPHORETIC TECHNIQUES. B Kohleisen, I Kalies, and JR Kalden, Institute for Clinical Immunology and Rheumatology, University of Erlangen-Nfirnberg, (FRG)

Antibodies to SSB and SSA were first described in sera from patients with Sjdgren's Syndrome and are considered as marker antibodies for this disease entity. Both antigens are associated with small ribonucleic acids. Different localization is shown for these ribonucleoproteins during different stages of cell cycle. SSB is predominantly found in the nuclear fraction, while SSA is of mainly cytoplasmic origin. In contrast to SSB, SSA is not detectable in extracts from rabbit thymus acetone powder (ENA) , a cytoplasmic extract of human spleen is prepared for determination of SSA-antibodies.

RNA and human spleen extracts were applied to isoelectric focusing (IEF) and SDS- polyacrylamide gelelectrophoresis (SDS-PAGE), and antibody reactivity was investigated by a subsequent immunoblot technique. An isoelectric range of 4.2-4.6 could be defined with monospecific standard sera against SSB. In SDS-PAGE, a molecular weight of 50 kd was detectable, with two minor degradation fragments of 45 and 43 kd. These results were confirmed by analysis of anti-SSB reactivity in immunoblots after Z-dimensional-gelelec- trophoresis (l.dim. IEF, Z-dim. SDS-PAGE). In contrast to SSB, SSA proved to consist of two protein components of 60 kd and a more intense band of 28 kd. In 2-D-electrophoresis a broad PI range from 7.0-8.4 was found corresponding to the 60 kd protein, while the