Comparison of Distinguishing Characteristics between Primary Sjögren’s Syndrome and Non-Primary Sjögren’s Syndrome Patients

Le résumé fourni par la source

Objectives: To evaluate potential systemic, oral and salivary distinguishing characteristics for patients with primary Sjögren’s syndrome (pSS) from non-primary Sjögren’s syndrome (non-pSS) patients. Methods: Forty patients referred for diagnosis of pSS underwent an interview including exocrine and non-exocrine symptoms and manifestations, assessment of fatigue using the Multidimensional Fatigue Inventory MFI-20, an oral (dental and periodontal status) and ocular (Schirmer’s test, tear break-up time and Lissamine green staining) examination, measurements of unstimulated (UWS) and chewing-stimulated whole saliva (SWS) flow rates, a labial salivary gland biopsy and test for serum autoantibodies. Results: Fourteen females and one male (aged 57±12 years) fulfilled the American-European Consensus Classification Criteria, whereas 22 females and 3 males (aged 55±14 years) did not. No significant differences were found in symptoms of oral and ocular dryness, concomitant systemic diseases, no. of prescribed medication, mean score of decayed-missed-filled-teeth, levels of plaque, gingival inflammation and probing depth. However, patients with pSS had lower UWS (0.04±0.06 ml/min vs. 0.13±0.12 ml/min, P=0.026) and SWS (0.47±0.50 ml/min vs. 0.84±0.60 ml/min, P=0.038) flow rates, and higher fatigue scores (P=0.046). Lymphocytic infiltration, i.e. with focus score ≥1,was found in the salivary gland biopsies from 47% of the patients with pSS and in none of those from non-pSS patients (mean focus score 2.3±4.0 vs. 0.02±0.06, P<0.001). In the remaining 53% of pSS patients, the salivary gland tissue was characterized by atrophy, fibrosis and diffuse inflammation. All patients with pSS had elevated levels of circulating anti-Ro/SSA serum autoantibodies as compared to 28% in the non-pSS group (P<0.001). Conclusion: Our preliminary findings indicate that oral, ocular and systemic symptoms and manifestations are poor distinguishing characteristics. A salivary gland biopsy with a focus score > 1 had a high predictive value for the diagnosis of pSS. Presence of anti-Ro/SSA autoantibodies had a high sensitivity for pSS but a lower specificity due to several false positive serum samples. Our on-going study includes a larger cohort to substantiate our preliminary findings and discover more specific biomarkers for pSS.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.