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Abstract：
Fatigue is the most commonly reported and debilitating extraglandular symptom of primary Sjögren\'s syndrome (pSS). Fatigue and exertional intolerance are hallmark symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We aimed to characterize fatigue and further symptoms among pSS patients and to determine whether there is a symptom overlap in pSS and ME/CFS. In 19 patients with pSS, we assessed pSS symptom severity and disease activity via questionnaires as well as the Canadian Consensus Criteria (CCC) for ME/CFS. Hand grip strength (HGS) and levels of α1-, α2-, β1-, β2-, M3- and M4-receptor-autoantibodies were measured. A subgroup of pSS patients exhibited severe fatigue and had higher severity of pain (p = 0.045), depression (p = 0.021) and sleep disturbances (p = 0.020) compared to those with less fatigue. Four of eighteen pSS patients fulfilled the CCC. HGS parameters strongly correlated with fatigue severity (p < 0.05), but strength fully recovered one hour after exertion in contrast to ME/CFS. Levels of β1-, β2- and M4-receptor-autoantibodies were elevated and correlated significantly with disease activity assessed by the ESSDAI (p < 0.05), but not fatigue severity. Only a minor subgroup of pSS patients fulfills the CCC, and post exertional malaise (PEM) is atypical, as it is primarily triggered by mental/emotional but not physical exertion. HGS assessment is an objective measure to assess overall fatigue severity.
摘要：
疲劳是原发性干燥综合征（pSS）最常报道和使人衰弱的颗粒外症状。疲劳和劳累不耐受是肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）的标志性症状。我们旨在表征pSS患者的疲劳和其他症状，并确定pSS和ME/CFS是否存在症状重叠。在19例pSS患者中，我们通过问卷调查和ME/CFS的加拿大共识标准(CCC)评估了pSS症状的严重程度和疾病活动.手握力（HGS）和α1-水平，α2-,β1-,β2-,测量了M3-和M4-受体-自身抗体。pSS患者的一个亚组表现出严重的疲劳和更严重的疼痛（p=0.045），抑郁症（p=0.021）和睡眠障碍（p=0.020）相比，疲劳较少。18名pSS患者中有4名符合CCC。HGS参数与疲劳严重程度密切相关(p<0.05)，但与ME/CFS相比，强度在运动后一小时完全恢复。β1-水平，β2-和M4-受体自身抗体升高，并与ESSDAI评估的疾病活动显着相关（p<0.05），但不是疲劳的严重程度。只有少数pSS患者符合CCC，劳累后不适(PEM)是非典型的，因为它主要是由精神/情感而不是体力消耗引发的。HGS评估是评估整体疲劳严重程度的客观指标。
