Features | Defined as/documented by |
SS associated | |
Clinical | |
EULAR SS disease activity index (ESSDAI) | 31 |
Arthralgias, arthritis | |
Raynaud’s phenomenon | |
Salivary gland enlargement (SGE) | |
Lung involvement | Pulmonary function tests and X-ray and/or CT scans |
Renal involvement | Persistent proteinuria and verification by renal biopsy |
Liver involvement | Liver biopsy indicative of primary biliary cirrhosis |
Palpable purpura | |
Vasculitis | |
Peripheral neuropathy | Nerve conduction studies |
Laboratory | |
Anti-Ro/SSA and/or anti-La/SSB autoantibodies | |
Rheumatoid factor | |
Complement C3 and C4 levels | |
Hypocomplementaemia | C4 <16 mg/dL and C3 <75 mg/dL |
Cryoglobulinaemia | |
Hypergammaglobulinaemia | Total gammaglobulins >2 g/L |
Anaemia | Haemoglobin <12 g/dL (females) and 13.5 g/dL (males) |
Leucopenia | White cell count <4000/mm3 |
Lymphopaenia | Lymphocyte count <1000/mm3 |
Neutropaenia | Neutrophil count <1500/mm3 |
Histological | |
Biopsy focus score | Number of lymphocytic foci/4 mm2 |
Germinal centre formation | |
Lymphoma associated | |
Non-Hodgkin’s lymphoma (NHL) subtype | |
Eastern Cooperative Oncology Group performance status | 32 |
Ann Arbor stage (I–IV) | 33 |
Number and type of involved sites | |
International Prognostic Index | 0–1 points: low risk, 2 points: low-intermediate risk, 3 points: high-intermediate risk, 4–5 points: high risk34 |
Splenomegaly | |
Lymphadenopathy | |
Presence of B symptoms | |
Serum lactate dehydrogenases | |
β2-microglobulin levels |
SS, Sjögren’s syndrome.