[Diagnosis of primary Sjogren's syndrome]

J T Gran, G Myklebust
Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række 2001 February 20, 121 (5): 563-6

BACKGROUND: 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.

MATERIAL AND METHODS: All 217 patients evaluated for sicca symptoms at Aust-Agder Central Hospital, Arendal, Norway from 1989 through 1998 were retrospectively reviewed.

RESULTS: 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.

INTERPRETATION: 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.

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