RT Journal Article SR Electronic T1 Bidirectional Relationship Between Primary Sjögren’s Syndrome and Non- Hodgkin’s Lymphoma: A Nationwide Population-based Study JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP jrheum.191027 DO 10.3899/jrheum.191027 A1 Li-Hui Wang A1 Wei-Ming Wang A1 Chun-Yu Lin A1 Sheng-Hsiang Lin A1 Chi-Chang Shieh YR 2020 UL http://www.jrheum.org/content/early/2020/01/10/jrheum.191027.abstract AB Objective Bidirectional relationships between some autoimmune diseases and non- Hodgkin’s lymphoma (NHL) may exist. We conducted this nationwide populationbased study in Taiwan to investigate whether there is a bidirectional relationship between primary Sjögren’s syndrome (pSS) and non-Hodgkin’s lymphoma (NHL). Methods Using the National Health Insurance Research Database of Taiwan, we identified 15,636 patients with new-onset pSS without previous cancer and 25,074 patients with new-onset NHL without previous pSS as two non-overlapping cohorts from 1998-2012, and followed them until 2013. Standardized incidence ratio (SIR) for NHL in the patients with pSS and SIR for pSS in the patients with NHL were compared with the general population. Results Among the 15,636 patients with pSS, 741 developed cancers, including 51 with NHL. The highest SIR of specific cancer risk in patients with pSS was that for NHL (SIR 4.6, 95% CI 3.4-6.0). Among the 25,074 patients with NHL, 49 developed pSS; the SIR was also increased (SIR 3.2, 95% CI 2.4-4.2). The risk was highest within one year after the diagnosis of each disease. Conclusion This nationwide population-based study is the first study to report a bidirectional relationship between pSS and NHL. Our findings may suggest being alert for the patients with pSS or NHL who have early signs of the other disease in the clinical care. The underlying mechanisms of the bidirectional relationship merit further investigation.