Sjögren's Smell, Taste Defects/Quality of Life | Arthritis Information

BANGOR, United Kingdom—Patients with primary Sjögren’s syndrome often experience impaired smell and taste, which affects their quality of life, researchers report in Rheumatology.¹

“These results suggest that chemosensory testing should be part of the routine assessment of patients with Sjögren’s syndrome,” conclude the researchers who were led by Usama F. Kamel, FRCSEd(OTO) MBBCh, of North West Wales NHS Trust in Bangor, UK. “This is more feasible now that user friendly and validated methods for taste and smell are available.”

Sjogren's senses may reflect mucin changes

Chemosensory perception may be abnormal in Sjögren's syndrome patients due to decreased mucin, which is an odorant carrier and recurrent rhinosinusitis, the study authors point out.

The new study comprised 28 Sjögren's syndrome patients and 37 controls. Researchers measured their smell and taste thresholds via standardized, validated tests, and their quality of life was assessed using the Short Form 12 (SF-12).

Among patients with Sjögren's syndrome, smell threshold was reduced by 1 point and taste threshold was reduced by 3.5 points, compared with controls. The physical and mental components of SF-12 were reduced by 14.2 points and 7.5 points, respectively, in the Sjögren's group when compared with controls. Taste threshold was significantly correlated with both the physical and the mental components of SF-12, the researchers report. Smell threshold correlated with the physical, but not the mental component. The threshold for sweet taste was least reduced among the patients with Sjögren's syndrome.

“This is the first study to show such a high degree of impairment, particularly for smell,” the researchers conclude.

Translating Sjogren's research into practice: treat smell and taste deficits; improve quality of life

“Along with dry mouth and dry eyes, we very commonly see abnormalities in smell and taste among Sjögren's syndrome patients,” says Alan Hirsch, MD, the neurological director of the Smell & Taste Treatment and Research Foundation in Chicago. “These patients also frequently present with burning mouth and develop pain and soreness of tongue, unfortunately artificial saliva is ineffective in treating these conditions and pain medications such as antidepressant and anticonvulsants cause further mouth dryness.”

Rheumatologists need to test for chemosensory deficits to better care for their Sjögren's syndrome patients. “They often just treat the other components such as the dryness or arthritic components but it is important to recognize taste and smell so they can do things to help with eating and improve their patients’ quality of life,” he says.

Reference

1. Kamel UF, Maddison P, Whitaker R. Impact of primary Sjögren's syndrome on smell and taste: effect on quality of life. Rheumatology. [epub ahead of print Sept. 14, 2009].