Clinical, Pathologic, and Serologic Studies in Sjögren's Syndrome
Authors: JOSEPH J. BUNIM
Journal: Annals of Internal Medicine (1964)

Clinical Staff Conference1 September 1964Clinical, Pathologic, and Serologic Studies in Sjögren's SyndromeCombined Clinical Staff Conference at the National Institutes of HealthJOSEPH J. BUNIM, M.D., F.A.C.P., W. WATSON BUCHANAN, M.D., PAUL T. WERTLAKE, M.D., LEON SOKOLOFF, M.D., KURT J. BLOCH, M.D., J. SWANSON BECK, M.D., F. PAUL ALEPA, M.D.JOSEPH J. BUNIM, M.D., F.A.C.P.Search for more papers by this author, W. WATSON BUCHANAN, M.D.Search for more papers by this author, PAUL T. WERTLAKE, M.D.Search for more papers by this author, LEON SOKOLOFF, M.D.Search for more papers by this author, KURT J. BLOCH, M.D.Search for more papers by this author, J. SWANSON BECK, M.D.Search for more papers by this author, F. PAUL ALEPA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-3-509 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDr. Joseph J. Bunim: This study on Sjögren's syndrome exemplifies the type of multidisciplinary clinical research for which the facilities and organization of the Clinical Center are especially welldesigned. We embarked on this study almost 5 years ago, and in the course of this time admitted to the Clinical Center 62 patients with this relatively rare disease. Other Institutes contributed patients and participated in some of the studies: the National Institute of Dental Research, the National Institute of Neurological Diseases and Blindness, the National Heart Institute, and the National Institute of Allergy and Infectious Diseases contributed cases or participated in...References1. : 1958 Revision of diagnostic criteria for rheumatoid arthritis. Arthritis Rheum. 2: 16, 1959. CrossrefMedlineGoogle Scholar2. BAIN GO: The pathology of Mikulicz-Sjögren disease in relation to disseminated lupus erythematosus: a review of the autopsy findings and presentation of a case. Canad. Med. Ass. J. 82: 143, 1960. MedlineGoogle Scholar3. RAMAGEKINNEAR JHWF: Keratoconjunctivitis sicca and the collagen diseases. Brit. J. Ophthal. 40: 416, 1956. CrossrefMedlineGoogle Scholar4. SILBERBERGDRACHMAN DHDA: Late-life myopathy occurring with Sjögren's syndrome. Arch. Neurol. (Chicago) 6: 428, 1962. CrossrefMedlineGoogle Scholar5. FUTCHER PH: Enlargement and round cell infiltration of the salivary glands associated with systemic disease. Bull. Hopkins Hosp. 105: 97, 1959. MedlineGoogle Scholar6. MORGANCASTLEMAN WSB: A clinicopathologic study of "Mikulicz's disease." Amer. J. Path. 29: 471, 1953. MedlineGoogle Scholar7. ANDERSONGRAYBECKKINNEAR JRKGJSWF: Precipitating autoantibodies in Sjögren's disease. Lancet 2: 456, 1961. CrossrefMedlineGoogle Scholar8. ANDERSONGRAYBECKBUCHANANMCELHINNEY JRKGJSWWAJ: Precipitating auto-antibodies in the connective tissue diseases. Ann. Rheum. Dis. 21: 360, 1962. CrossrefMedlineGoogle Scholar9. POMERANTZHERDTKETCHAM MJAS: Clinical evaluation of lymphangiography. Surgery 54: 270, 1963. MedlineGoogle Scholar10. MELLORSHEIMERCORCOSKORNGOLD RCRJL: Cellular origin of rheumatoid factor. J. Exp. Med. 110: 875, 1959. CrossrefMedlineGoogle Scholar11. MELLORSNOWOSLAWSKIKORNGOLDSENGSON RCALBL: Rheumatoid factor and the pathogenesis of rheumatoid arthritis. J. Exp. Med. 113: 475, 1961. CrossrefMedlineGoogle Scholar12. SCHAMAUN M: Zur pathologischen Anatomie der sog. Macroglobulinaemie Waldenstroem. Schweiz. Z. Allg. Path. 17: 25, 1954. Google Scholar13. LEHLBACH WK: Ein beitrag zur Morphologie der Makroglobulinämie Waldenström. Frankfur. Z. Path. 68: 440, 1957. MedlineGoogle Scholar14. DUTCHERFAHEY TFJL: The histopathology of the macroglobulinemia of Waldenström. J. Nat. Cancer Inst. 22: 887, 1959. CrossrefMedlineGoogle Scholar15. DUTCHERFAHEY TFJL: Immunocytochemical demonstration of intranuclear localization of 18S gamma macroglobulin in macroglobulinemia of Waldenström. Proc. Soc. Exp. Biol. Med. 103: 452, 1960. CrossrefMedlineGoogle Scholar16. BRITTINTANAKABRECHER GMYG: Intranuclear inclusions in multiple myeloma and macroglobulinemia. Blood 21: 335, 1963. CrossrefMedlineGoogle Scholar17. MORGAN WS: The probable systemic nature of Mikulicz's disease and its relation to Sjögren's syndrome. New Eng. J. Med. 251: 5, 1954. CrossrefMedlineGoogle Scholar18. KUSSMAULMAIER AR: Ueber eine bisher nicht beschriebene eigenthümliche Arterienerkrankung (Periarteritis nodosa), die mit Morbus Brightii und rapid fortschreitender allgemeiner Muskellähmung einhergeht. Deutsch. Arch. Klin. Med. 1: 484, 1866. Google Scholar19. BUNIMTALAL JJN: The association of malignant lymphoma with Sjögren's syndrome. Trans. Ass. Amer. Physicians 76: 45, 1963. Google Scholar20. BLOCHWOHLSHIPOGLESBYBUNIM KJMJIIRBJJ: Sjögren's syndrome. I. Serologic reactions in patients with Sjögren's syndrome with and without rheumatoid arthritis. Arthritis Rheum. 3: 287, 1960. CrossrefMedlineGoogle Scholar21. OVARY Z: Immediate reactions in the skin of experimental animals provoked by antibody-antigen interaction, in Progress in Allergy, edition V, edited by KALLÓS, P., and WAKSMAN, B. H., S. Karger, Basel and New York, 1958, p. 459. Google Scholar22. DEICHERHOLMANKUNKELOVARY HGHRHGZ: Passive cutaneous anaphylaxis reactions with a systemic lupus erythematosus serum factor and isolated DNA. J. Immun. 84: 106, 1960. MedlineGoogle Scholar23. BUCHANANCROOKSALEXANDERKOUTRASWAYNEGRAY WWJWDDAEJKG: Association of Hashimoto's thyroiditis and rheumatoid arthritis. Lancet 1: 245, 1961. CrossrefGoogle Scholar24. HACKETTBEECHFORBES EMIJ: Thyroglobulin antibodies in patients without clinical disease of the thyroid gland. Lancet 2: 402, 1960. CrossrefMedlineGoogle Scholar25. GOUDIEANDERSONGRAY RBJRKG: Complement-fixing antithyroid antibodies in hospital patients with asymptomatic thyroid lesions. J. Path. Bact. 77: 389, 1959. CrossrefMedlineGoogle Scholar26. BLOCHBUNIMWOHLZVAIFLER KJJJMJNJ: Unusual occurrence of multiple tissue component antibodies in Sjögren's syndrome. Trans. Ass. Amer. Physicians 73: 166, 1960. Google Scholar27. BECK JS: Variations in the morphological patterns of "autoimmune" nuclear fluorescence. Lancet 1: 1203, 1961. CrossrefMedlineGoogle Scholar28. BECK JS: Auto-antibodies to cell nuclei. Scot. Med. J. 8: 373, 1963. CrossrefMedlineGoogle Scholar29. BUNIM JJ: A broader spectrum of Sjögren's syndrome and its pathogenetic implications. Ann. Rheum. Dis. 20: 1, 1961. CrossrefMedlineGoogle Scholar30. BLOCHBUNIM KJJJ: Sjögren's syndrome and its relation to connective tissue diseases. J. Chronic Dis. 16: 915, 1963. CrossrefMedlineGoogle Scholar31. WALLERVAUGHAN MVJR: Use of anti-Rh sera for demonstrating agglutination activating factor in rheumatoid arthritis. Proc. Soc. Exp. Biol. Med. 92: 198, 1956. CrossrefMedlineGoogle Scholar32. GRUBBLAURELL RA: Hereditary serological human serum groups. Acta Path. Microbiol. Scand. 39: 390, 1956. CrossrefMedlineGoogle Scholar33. HARBOE M: A new haemagglutinating substance in the Gm system, anti-Gm. Nature 183: 1468, 1959. CrossrefMedlineGoogle Scholar34. HARBOELUNDEVALL MJ: A new type in the Gm system. Acta Path. Microbiol. Scand. 45: 357, 1959. CrossrefMedlineGoogle Scholar35. STEINBERGGILESSTAUFFER AGBDR: A Gm-like factor present in Negroes and rare or absent in whites: Its relation to Gma and Gmxl. Amer. J. Hum. Genet. 12: 44, 1960. MedlineGoogle Scholar36. BRANDTZAEGFUDENBERGMOHR BHJ: The Gm(r) serum group. Acta Genet. (Basel) 11: 170, 1961. Google Scholar37. THOMASKAMPF KG: Die vererbbaren Gm-serumeiweissgruppen—ein neuer Faktor, Gm-Dresden, in Diesem System. Deutsch Gesundh. 16: 1185, 1961. MedlineGoogle Scholar38. ROPARTZRIVATROUSSEAU CLPY: Deux nouveaux facteurs héréditaires dans les systems héréditaires de gamma-globulines, le Gm(e) et Inv(l). Proceedings, Ninth Congress International Society of Blood Transfusion, pp. 54-55, 1962. Google Scholar39. WALLERHUGHESTOWNSENDFRANKLINFUDENBERG MRDJIECH: New serum group, Gm(p). Science 142: 1321, 1963. CrossrefMedlineGoogle Scholar40. STEINBERG AG: Progress in the study of genetically determined human gamma globulin types (the Gm and Inv groups), in Progress in Medical Genetics, Vol. II, edited by STEINBERG, A. G., BEARN, A. G., Grune and Stratton, New York, 1962, p. 1. Google Scholar41. ROTHMANBLOCKHAUSER SMFV: Sjögren's syndrome associated with lymphoblastoma and hypersplenism. Arch. Derm. Syph. 63: 642, 1951. MedlineGoogle Scholar42. HARDISON CS: Personal communication. Google Scholar43. LATTES R: Thymoma and other tumors of the thymus: an analysis of 107 cases. Cancer 15: 1224, 1962. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bethesda, MarylandThis is an edited transcription of a combined clinical staff conference at the Clinical Center, Bethesda, Maryland, by the National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, United States Public Health Service, Bethesda, Maryland.Dr. Joseph J. Bunim, the late Clinical Director of the National Institute of Arthritis and Metabolic Diseases, died on July 8, 1964. He had been instrumental not only in initiating and organizing the Clinical Staff Conferences of the National Institutes of Health, but also in arranging for their publication in the ANNALS OF INTERNAL MEDICINE. Until last year, when the burden of his many other duties forced him to relinquish the task, he supervised the selection of conferences for publication and edited the transcripts. His subsequent advice and assistance to the present Editor were invaluable and will be sorely missed.Requests for reprints should be addressed to Clinical Director, National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Maryland 20014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySialoscintigraphy – Shopworn or Bestselling? A Traditional Procedure with New Prominent Role in Theranostics and Immuno-OncologyImaging of the major salivary glandsAnti‐Citrullinated Peptide Antibodies in Sudanese Patients with L eishmania donovani Infection Exhibit Reactivity not Dependent on CitrullinationThe clinical value and histopathological correlation of lacrimal scintigraphy in patients with primary Sjögren’s syndromeThe Second Definition of Sjögren's Syndrome as an Autoimmune DisorderQuantitative and visual evaluation of salivary and thyroid glands in patients with primary Sjögren's syndrome using salivary gland scintigraphy: relationship with clinicopathological features of salivary, lacrimal and thyroid glandsSalivary gland scintigraphy with 99mTc-pertechnetate in Sjogren's syndrome: relationship to clinicopathologic features of salivary and lacrimal glandsSJÖGREN'S SYNDROMESjögren's syndrome in the adolescentGenetically-Engineered Antibodies: Tools for the Study of Diverse Properties of the Antibody MoleculePrevalence of anti-Fab antibodies in patients with autoimmune and infectious diseasesQuantification of cross-reactive idiotype-positive rheumatoid factor produced in autoimmune rheumatic diseases. An indicator of clonality and B cell proliferative mechanismsPeriductal lymphocytic infiltration of salivary glands in Sjo¨gren's syndrome with relation to clinical and immunologic findingsLacrimal and salivary immunoglobulins in Sjögren's syndromeActivation of peripheral blood lymphocytes in patients with primary sj�gren's syndromeBenign Lymphoepithelial Lesion of the Submandibular GlandsStudies on the Sicca Syndrome in Patients with Rheumatoid ArthritisAnti-Ro (SS-A) and Anti-La (SS-B) in patients with Sjögren's syndromeDevelopment of malignant lymphoma in myoepithelial sialadenitis (Sj�gren's syndrome)The Dry Eye SyndromeThe so-called ‘benign lymphoepithelial lesion’Cardiopulmonary Manifestations of Progressive Systemic SclerosisClinical Utilization of Alkaline Phosphatase MeasurementsBenign lymphoepithelial lesion (Mikulicz's disease) of the salivary gland: An ultrastructural studyThe epithelial response in keratitis sicca and keratitis herpetica (an experimental and clinical study)Vanishing tumor of the abdomen in patient with Sj�gren's syndromeSialochemical Examinations in Non-Tumorous Parotid EnlargementsImmunologìe Diseases of the Salivary GlandsExperimental Allergic Sialoadenitis. X. Chronic Destructive Parotitis Induced in Immunized Rats by Daily Intraductal Challenges with AntigenPathology of Lymphoid Tissue in Rheumatoid Arthritis and Allied DiseasesParotid calcifications and cementomas in a patient with Sjogren's Syndrome and idiopathic thrombocytopenic purpuraA sialochemical study on patients with Sjögren's syndromeKeratoconjunctivitis SiccaResorptive arthropathy and the opera-glass hand syndromeSjögren's Syndrome—Newer Aspects of Research, Diagnosis, and TherapyNORMAN A. CUMMINGS, M.D., GERALD L. SCHALL, M.D., RICHARD ASOFSKY, M.D., LARRY G. ANDERSON, M.D., NORMAN TALAL, M.D.Malignant histopathologic counterpart of the benign lymphoepithelial lesionStudies on the Sicca Syndrome in Patients with Rheumatoid ArthritisBenign lymphoepithelial lesion of the parotid glands associated with reticulum cell sarcoma.Report of a case and review of the literatureSjögren's syndrome: Effect of radiation therapy on serum and saliva proteinsSjögren's syndromeOccurrence of antibody to salivary duct epithelium in Sjogren's disease, rheumatoid arthritis, and other arthritides. A clinical and laboratory study.Oesophageal Abnormalities in Sjögren's SyndromeExtrasalivary lymphoid abnormalities in Sjögren's syndrome (reticulum cell sarcoma, “pseudolymphoma,” macroglobulinemia)Ocular Lesions in Relapsing Polychondritis and Other Rheumatoid SyndromesRheumatoid Factor in Takayashu SyndromeCarcinoma of the parotid gland associated with benign lymphoepithelial lesion (Mikulicz's disease) in Sjögren's syndromeCase 20-1966Fluorescenzmikroskopischer Nachweis antinucleärer Faktoren bei Lupus erythematodes und verwandten ErkrankungenTHE FREQUENT OCCURRENCE OF HYPERGAMMAGLOBULINEMIA AND MULTIPLE TISSUE ANTIBODIES IN SJÖGREN'S SYNDROME 1 September 1964Volume 61, Issue 3Page: 509-530KeywordsAntigensArthritisHeart diseasesLymphomaMetabolic disordersPathogensPolymyositisPrevention, policy, and public healthReactive arthritisScleroderma Issue Published: 1 September 1964 PDF downloadLoading ...