Clinical and laboratory features of Sjogren's syndrome in young women with previous postpartum thyroiditis

Objective. To eludicate the possible development of Sjogren's syndrome in young women with previous postpartum thyroiditis, a clinical and laboratory case-control followup study was undertaken. Methods. Forty female patients (mean age 36 years) with well documented postpartum thyroiditis 5 years previously and 30 healthy mothers (mean age 36 years) who all had undergone normal partus an average of 5 years previously, were included in the study. Results. Symptoms of dry eyes, caries, arthralgias, swollen joints and fatigue were reported significantly more often in women with previous postpartum thyroiditis compared with healthy mothers of the same age (p < 0.05). Using an ELISA with purified (SSA)Ro and (SSB)La proteins derived from a human cell line as antigens, 34% of the women were anti-SSB positive and 46% were anti-SSA positive at followup. Furthermore, 15/35 women with a history of postpartum thyroiditis (43%) had objectively impaired tear and/or saliva production; 5 of 24 investigated women had keratoconjunctivitis sicca (KCS) and 2 of 7 salivary gland biopsies showed chronic lymphocytic sialadenitis. Three women (8.6%) had the combination of KCS and xerostomia. Conclusion. Laboratory and clinical features of Sjogren's syndrome are frequently seen in younger women with previous postpartum thyroiditis.