Research indicates that rheumatic disorders are accompanied by decreased chemosensory function. The present study aimed to specifically evaluate this issue in patients with rheumatoid arthritis (RA).
212 RA patients (43 men, 169 women, mean age 59 ± 13.3 years), and 30 healthy controls (10 men, 20 women, mean age 40 ± 15.3 years), were included in this study. Chemosensory measurements consisted of olfactory testing using the “Sniffin’ Sticks” test battery (with odor thresholds, odor discrimination and odor identification; OT, OD, OI) and gustatory testing on a suprathreshold and a quasi-threshold level using “taste sprays” and “taste strips”, respectively. In addition, inflammatory markers (erythrocyte sedimentation rate, C-reactive protein) and RA autoantibodies (anti-cyclic citrullinated peptides, RA factors) were evaluated.
Olfactory measurements showed 4% of the RA patients functionally anosmic and 40% hyposmic. RA patients scored significantly lower in suprathreshold olfactory tests (OD, OI) compared to controls (OI: 12.5 ± 2.5 vs. 14.1 ± 1.3; OD: 11.3 ± 2.7 vs. 12.9 ± 1.7). In addition, RA patient had decreased taste function compared to healthy individuals (10.4 ± 2.6 vs. 11.7 ± 1.7). Chemosensory function did not correlate with parameters related to the severity of disease.
Chemosensory function (taste, OD and OI) appears to be decreased in RA patients. In contrast, OT was not affected. Changes in chemosensory function seem to be independent of disease parameters such as duration of disease or disease activity.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
AWMF Leitlinie: management der frühen rheumatoiden arthritis. AWMF register no. 060/002. Klasse S3
Aletaha D, Neogi T, Silman A, Funovits J, Felson DT, Bingham CO, Birnbaum NS et al (2010) Rheumatoid arthritis classification criteria. Arthritis Rheum 62:2569–2581
Stepan J, Bremova A, Susta A (1965) Taste perception in patients with rheumatoid arthritis. Acta Rheum Scand 11:247–257
Steinbach S, Proft F, Schulze-Koops H, Hundt W, Heinrich P, Schulz S, Gruenke M (2011) Gustatory and olfactory function in rheumatoid arthritis. Scand J Rheumatol 40:169–177
Akyol L, Günbey E, Karlı R, Önem S, Özgen M, Sayarlıoğlu M (2016) Evaluation of olfactory function in Behçet’s disease. Eur J Rheumatol 3:153–156
Kamel UF, Maddison P, Whitaker R (2009) Impact of primary Sjogren’s syndrome on smell and taste: effect on quality of life. Rheumatology (Oxford) 48:1512–1514
Yalcinkaya E, Basaran MM, Erdem H, Kocyigit M, Altundag A, Hummel T (2019) Olfactory dysfunction in spondyloarthritis. Eur Arch Otorhinolaryngol 276:1241–1245
Prevoo MLL, van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LBA, van Riel PLCM (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48
Raspe H, Hagedorn U, Tetal K (1990) Der funktionsfragebogen Hannover (FFbH): ein instrument zur funktionsdiagnostik bei polyartikulären gelenkerkrankungen. In: Siegrist J (Hrsg) Wohnortnahe betreuung rheumakranker. Ergebnisse sozialwissenschaftlicher evaluation eines modellversuchs. Schattauer, Stuttgart
Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) “Sniffin sticks”: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22:39–52
Walliczek U, Negoias S, Hähner A, Hummel T (2016) Assessment of chemosensory function using “Sniffin’ sticks”, taste strips, taste sprays, and retronasal olfactory tests. Curr Pharm Des 22:2245–2252
Welge-Luessen A, Leopold DA, Miwa T (2013) Smell and taste disorders-diagnostic and clinical work-up. In: Welge-Luessen A, Hummel T (eds) Management of smell and taste disorders—a practical guide for clinicians. Thieme, Stuttgart, pp 49–57
Hummel T, Welge-Lüssen A (2008) Riech- und schmeckstörungen: physiologie, pathophysiologie und therapeutische ansätze, 1st edn. Thieme, Stuttgart
Landis BN, Welge-Luessen A, Bramerson A, Bende M, Mueller CA, Nordin S, Hummel T (2009) “Taste strips”—a rapid, lateralized, gustatory bedside identification test based on impregnated filter papers. J Neurol 256:242–248
Hummel T, Kobal G, Gudziol H, Mackay-Sim A (2007) Normative data for the “Sniffin’ sticks” including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 264(3):237–243
Sayilir S, Cullu N, Mengi G, Ekiz T (2019) Evaluation of olfactory bulb volumes in patients with rheumatoid arthritis: a retrospective study. Arch Rheumatol 34:334–337
Laudisio A, Navarini L, Margiotta DPE, Fontana DO, Chirella I, Spitaleri D, Bandinelli S, Gemma A, Ferrucci L, Incalzi RA (2019) The association of olfactory dysfunction, frailty and mortality is mediated by inflammation: results from the InCHIANTI Study. J Immunol Res 2019:3128231
Henkin R, Schmidt L, Vlicu I (2013) Interleukin 6 in hyposmia. JAMA Otolaryngol Head Neck Surg 139:728
Doty RL, Kamath V (2014) The influences of age on olfaction: a review. Front Psychol 5:20
Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehne A, Holbrook E, Hong SC, Hornung D, Huttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjarne P, Stuck BA, Vodicka J, Welge-Luessen A (2017) Position paper on olfactory dysfunction. Rhinol Suppl 54:1–30
Jensen SB, Mouridsen HT, Bergmann OJ, Reibel J, Brünner N, Nauntofte B (2008) Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:217–226
Haehner A, Hummel T, Hummel C, Sommer U, Jungshanns S, Reichmann H (2007) Olfactory loss may be a first sign of idiopathic Parkinson’s disease. Mov Disord 22:839–842
Haehner A, Hummel T, Reichmann H (2009) Olfactory dysfunction as a diagnostic marker for Parkinson’s disease. Expert Rev Neurother 9:1773–1779
There have no funding been received.
Conflict of interest
The authors declare that there are no conflicts of interests regarding the content of this manuscript. No funding has been received. No financial disclosures.
The study has obtained ethical approval by the ethical committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (TU Dresden; EK502112015) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent of all patients has been received.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Walliczek-Dworschak, U., Wendler, J., Khan, T. et al. Chemosensory function is decreased in rheumatoid arthritis. Eur Arch Otorhinolaryngol 277, 1675–1680 (2020). https://doi.org/10.1007/s00405-020-05874-3
- Olfactory function
- Rheumatoid arthritis
- Rheumatoid disorder