Pancreatic exocrine dysfunction in rheumatoid arthritis and its relation with dry eye

Rheumatoid arthritis (RA) is a common disease, affecting mainly the joints but also cause systemic complications. Sjogren's Syndrome (SjS) is classified as a rheumatic autoimmune chronic disease which is characterized with destruction of exocrine glands and commonly associated with RA. Function of the exocrine pancreas is the secretion of enzymes fluid into the gut to digest and absorb nutrients Pancreatic exocrine insufficiency occurs due to different disease and if untreated malnutrisyon develops. RA, itself does not lead to increase gastrointestinal morbidity. However several studies of RA have been reported Suggesting the destruction of exocrine pancreatic glands. The purpose of the study is that; does RA cause pancreatic exocrine disfunction? For evaluating this, we rıled out secondary SjS seen amoung RA patients by using Schirmer test. The study include 20 SjS, 20 Schirmer's test result is detected <5 mm with RA (RAI), 20 Schirmer's test result is detected >15 mm with RA (RAII), a total of 60 patients and 20 healthy volunteers. Fort his purpose the RA and SjS patients who don't have Schirmer test results in the last 6 months, are classified according to their Schirmer's test results. Patients with known diabetes, drugs anda ge that damege pancreatic exocrine function and Schirmer's test were excluded. Pancreatic imaging was performed with abdominal ultrasound. Faeces samples collected from patients and healthy subjects in order to determine the pancreatic fecal elastase 1 level and simultaneous C reactive protein levels measured. As a result, we found statistically significant decrease in fecal elastase levels in RAI and pSjS groups compared to the control group. Also fecal elastase levels were detected statistically significant decrease in pSjS than RAII group. There were differences of fecal elastase levels between RAI and RAII, not statistically significant. The result of our study is that; the pancreatic exocrine dysfunction seen in RA patients is not the primer cause RA disease. This is the result of sSjS disease seen among the RA patients additionally. Disease duration, gender, age, autoimmune thyroid disease and drugs did not affect elastase levels.