Table 3

Revised rules for classification

For primary SS
In patients without any potentially associated disease, primary SS may be defined as follows:
    a. The presence of any 4 of the 6 items is indicative of primary SS, as long as either item IV (Histopathology) or VI (Serology) is positive
    b. The presence of any 3 of the 4 objective criteria items (that is, items III, IV, V, VI)
    c. The classification tree procedure represents a valid alternative method for classification, although it should be more properly used in clinical-epidemiological survey
For secondary SS
In patients with a potentially associated disease (for instance, another well defined connective tissue disease), the presence of item I or item II plus any 2 from among items III, IV, and V may be considered as indicative of secondary SS
Exclusion criteria:
Past head and neck radiation treatment
Hepatitis C infection
Acquired immunodeficiency disease (AIDS)
Pre-existing lymphoma
Graft versus host disease
Use of anticholinergic drugs (since a time shorter than 4-fold the half life of the drug)