| |
Sjögren's
syndrome is an autoimmune exocrinopathy characterized by complaints
of dry mouth and eyes, diminished exocrine gland function, and
evidence of systemic autoimmunity. The estimated prevalence of
Sjögren's syndrome in the United States is 2-4 million persons,
90% of whom are women (Carsons,
2001). The condition is under diagnosed, in part because the
presenting symptoms are non-specific, but also due to low awareness
of patients and health care professionals.
All patients
complaining of dry mouth should be asked if they also have dry
eyes or other sicca complaints, such as dryness of the nose, throat,
skin or vagina. Serological studies can be helpful in diagnosis
of Sjögren's syndrome. The presence of autoantibodies is
an important criterion for diagnosis. Establishing a diagnosis
is important, not just to prevent complications associated with
exocrine dysfunction, but also to monitor carefully for lymphoma.
Sjogren's syndrome patients have a significantly increased risk
of development of B cell lymphomas.
There is now
a widely accepted set of classification criteria to assist in
diagnosis of Sjögren's syndrome (Vitali
et al., 2002). This will help to standardize diagnostic approaches
for the disorder and provides a firm basis for clinical trials.
Patients in clinical studies should be classified based on these
criteria. Criteria include subjective oral and ocular dryness,
objective measures of lacrimal and salivary dysfunction, and evidence
of systemic autoimmunity. Presence of 4 of 6 criteria are required
for confirmation of a case. [
See classification criteria]
|