Sjögren's Syndrome in Scurvy

Abstract

Five men were deprived of ascorbic acid until they became scorbutic. During deficiency of ascorbic acid, Sjögren's syndrome became apparent in two subjects. In these two and one other keratoconjunctivitis sicca developed. All five had one or more manifestations of the sicca syndrome, including keratoconjunctivitis sicca, enlargement of the salivary glands, xerostomia, dry skin, excessive hair loss, dental decay and recurrent breakdown of dental restorations. Sjögren's syndrome or component features of the syndrome developed when the men had obvious clinical signs of scurvy. Evidence of deficiency other than of ascorbic acid was absent. During repletion with ascorbic acid, as plasma levels of ascorbic acid rose and the size of the body pool of the vitamin increased, the signs of scurvy and of Sjögren's syndrome disappeared. An association between scurvy and Sjögren's syndrome therefore seems apparent.