Diagnosis of primary Sjogren's syndrome
Gran, J.T.; Myklebust, G.
Tidsskrift for den Norske Laegeforening Tidsskrift for Praktisk Medicin Ny Raekke 121(5): 563-566
2001
ISSN/ISBN: 0029-2001 PMID: 11301610 Document Number: 540226
The diagnosis of primary Sjögren's syndrome largely depends on pathological findings at lower lip biopsy, or the presence of anti SSA and/or anti SSB antibodies. The present study evaluated which clinical and laboratory features among patients with sicca symptoms could predict a positive biopsy. All 217 patients evaluated for sicca symptoms at Aust-Agder Central Hospital, Arendal, Norway from 1989 through 1998 were retrospectively reviewed. 136 biopsies were performed. 59 patients were diagnosed with primary Sjögren's syndrome. A reduced Schirmer I test combined with either an elevated ESR, positive ANA or elevated serum gammaglobulin had a high positive predictive value for primary Sjögren's syndrome. Among patients with sicca symptoms, those with laboratory evidence of inflammation, autoimmunity or exocrine dysfunction should be subjected to a lower lip biopsy for a final diagnosis of primary Sjögren's syndrome.