Sjögren's Syndrome Associated with Vitamin B₁₂ Deficiency

Summary

Three patients showing Sjögren's syndrome in association with macrocytic anemia due to vitamin B₁₂ deficiency are described. Antibodies to parietal cells, intrinsic factor and salivary protein were investigated; positive test results were obtained in different combinations. Addisonian pernicious anemia as well as vitamin B₁₂-malabsorption because of anti-intrinsic factor antibodies in gastric juice and/or malabsorption due to changes in the intestinal wall induced by Sjögren's syndrome are possible etiological factors. A case of Sjögren's syndrome associated with positive anti-parietal cell antibodies and histamine-refractory achylia is also reported. The concurrence of these two diseases known to be associated with autoimmune responses suggests the possibility of similar pathogenesis.