Abstract
Background: Allergen-specific immunotherapy (SIT) is a well-documented treatment for allergic rhinitis, asthma, and allergy to bee venoms. Side-effects of SIT in long-term have not been well documented yet. Herein, we report a case of Sjögren’s syndrome following SIT. Case: The patient, a 25-year-old Caucasian woman, was started on subcutaneous grass-pollen immunotherapy. The patient’s autoantibodies before the SIT screening tests were negative. We determined that anti-extractable nuclear antigen (ENA) was positive (ENA = 98.4, normal range 0–25 U) on routine screening tests at 44 weeks of her treatment, and then SIT was discontinued. The patient complained of burning and itching in her eyes for 6 months. Schirmer’s and salivary flow tests were positive. Although antinuclear antigen and rheumatoid factor were negative, anti-SS-A/Ro was positive. Viral hepatitis markers were negative. Minor salivary-gland biopsy was performed, which showed grade 4 sialoadenitis. The HLA type of the patient was B55 (B22), Bw6, Cw1 for class I and DR11, DR52, DQ7 (DQ3) for class II. After the immunotherapy had been stopped, there were no changes in the symptoms and laboratory findings of the patient during the 1st year of follow-up. Conclusion: This is the first case to be reported of Sjögren’s syndrome following SIT. Patients undergoing SIT must be carefully followed up for the development of autoimmunity and an autoimmune disease.
References
Fox RI, Stern M, Michelson P (2000) Update in Sjögren’s syndrome. Curr Opin Rheumatol 12:391–398
Malling HJ (2001) Allergen-specific immunotherapy in allergic rhinitis. Curr Opin Allergy Clin Immunol 1:43–46
O’Hollaren MT (2003) Optimizing allergen immunotherapy, a disease-modifying treatment. Selected of coverage of the 60th anniversary meeting of the American Academy of Allergy. Denver, Colorado
Chisholm DM, Mason DK (1968) Labial salivary gland biopsy in Sjögren’s disease. J Clin Pathol 21:656–660
Greenspan JS, Daniels TE, Talal N, Sylvester RA (1974) The histopathology of Sjögren’s syndrome in labial salivary gland biopsies. Oral Surg Oral Pathol 37:217–230
Vitali C, Bombardieri S, Jonsson R et al (2002) Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European consensus group. Ann Rheum Dis 61:554–558
Toussirot E, Lohse A, Wendling D, Mougin C (2000) Sjögren’s syndrome occurring after hepatitis B vaccination. Arthritis Rheum 43:2139–2140
Unoki H, Moriyama A, Tabaru A, Masumoto A, Otsuki M (1996) Development of Sjögren’s syndrome during treatment with recombinant human interferon-alpha-2b for chronic hepatitis C. J Gastroenterol 1:723–727
Darwaza A, Lamey PJ, Conel JM (1988) Hydrallazine-induced Sjögren’s syndrome. Int J Oral Maxillofac Surg 17:92–93
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Turkcapar, N., Kinikli, G., Sak, S.D. et al. Specific immunotherapy-induced Sjögren’s syndrome. Rheumatol Int 26, 182–184 (2005). https://doi.org/10.1007/s00296-005-0606-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-005-0606-x