@article {Walker2406, author = {Jennifer Walker and Tom Gordon and Sue Lester and Sarah Downie-Doyle and Doug McEvoy and Kevin Pile and Sally Waterman and Maureen Rischmueller}, title = {Increased severity of lower urinary tract symptoms and daytime somnolence in primary Sj{\"o}gren{\textquoteright}s syndrome.}, volume = {30}, number = {11}, pages = {2406--2412}, year = {2003}, publisher = {The Journal of Rheumatology}, abstract = {OBJECTIVE: Functional antimuscarinic receptor autoantibodies have recently been described in both primary and secondary Sj{\"o}gren{\textquoteright}s syndrome (SS) in a mouse bladder contraction assay. Most patients with these antibodies complained of severe lower urinary tract disturbances, which are not a recognized feature of SS. We compared the severity of self-reported urological symptoms, daytime somnolence, and fatigue between a cohort of patients with primary SS and controls with osteoarthritis (OA). METHODS: Female patients were recruited from rheumatology outpatient clinics at 2 hospitals. The American Urological Symptom Index (AUA-7), Epworth Sleepiness Scale, and FACIT-F fatigue self-administered instruments were employed. Results were obtained for 76 patients with primary SS and 43 controls (response rates 85\% and 67\%, respectively). The patient groups were matched for parity, hormone replacement and diuretic therapy, and number of bladder operations and urinary tract infections, although OA patients were slightly older. RESULTS: AUA-7 urological symptoms were more severe in patients with primary SS compared to OA controls (p = 0.039). Severe urological symptoms were reported by 61\% of primary SS patients compared with 40\% of OA controls. This difference was predominantly attributable to bladder irritability associated with urgency (p = 0.015) and not nocturia (p = 0.85). Epworth Sleepiness Scale scores were also more severe in primary SS patients compared to OA controls (p = 0.02), independent of nocturia. The FACIT-F fatigue severity scores were not significantly different between patient groups (p = 0.14). CONCLUSION: Urological symptoms and daytime somnolence may be previously unrecognized symptoms of primary SS. These symptoms are consistent with functional disturbances of muscarinic receptors, possibly mediated by muscarinic receptor autoantibodies.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/30/11/2406}, eprint = {https://www.jrheum.org/content/30/11/2406.full.pdf}, journal = {The Journal of Rheumatology} }