Background Sjögren’s syndrome (SS) is defined as a chronic autoimmune condition. According to the preliminary European classification criteria1 currently in use, it is possible to diagnose SS without the evidence of autoantibodies (SSA/SSB) or specific salivary gland inflammation. In Norway, these criteria are often used as a guidance for the diagnosis in the clinical setting. In the recently proposed modification of the European criteria,2 the presence of autoantibodies or salivary gland inflammation is obligatory.
Objectives To investigate whether out-patients with a clinical diagnosis of SS satisfied formal criteria, and the proportion of patients who satisfied the proposed modified criteria and thus had indication of an autoimmune process.
Methods All out-patients with visits coded M35.0 (ICD-10) at the Rheumatology clinic from January 1, 1999 to November 1, 2000, were included in the study. Patients with secondary SS, observational patients and those misclassified were excluded.
Results Of 10720 consultations, 457 (4,3%) were coded M35.0. Patients typically had 1–3 consultations in the period. After exclusions, there remained 203 patients who were coded correctly according to the clinical diagnosis in the journal. Of these, 116 (57.1%) satisfied the current European criteria, and 83 (40.9%) satisfied the proposed modified criteria. Thirty-four (29.3%) of the patients satisfying current criteria lost the diagnosis of SS according to the modified criteria, while only one patient who did not previously satisfy criteria received the diagnosis.
Conclusion Sicca-symptoms and signs may have a variety of causes. In our study only 40.9% of the patients with a clinical diagnosis of SS satisfied the proposed modified European criteria and had evidence of SS as an autoimmune condition. Approximately one third of the patients meeting the preliminary European criteria for SS, lost the diagnosis according to the modified criteria.
Vitali C, Bombardieri S, Moutsopoulos HM, et al. Preliminary criteria for the classification of Sjogren’s syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum. 1993;36:340–7
Vitali C, Bombardieri S, Moutsopoulos HM, and the European Study Group for the Classification Criteria for Sjögren’s syndrome. A proposal for modification of the European classification criteria for Sjögren’s syndrome (Abstract). Clin Exp Rheum. 2000;18:118
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