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sjogren_syndrome [2023/03/07 13:57] – Scott Larsonsjogren_syndrome [2026/07/28 12:24] (current) – [Diagnostic Criteria 2016] Scott Larson
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 ====== Sjögren Syndrome ====== ====== Sjögren Syndrome ======
 +Autoimmune disease of that affects the lacrimal and salivary glands causing dryness of the ocular surface and mucous membranes. It often seriously affects other organ systems, such as the lungs, kidneys, and nervous system. 
  
-===== Diagnostic Criteria 2016 =====+===== When to Suspect ===== 
 +  * Dry Mouth, fatigue, joint/muscle pain 
 +  * Other autoimmune diseases: Rheumatoid Arthritis, Systemic Lupus Erythematosis, Scleroderma, Undifferentiated connective tissue disease, Reynaud, Hashimoto, Chron's Disease 
 +  * Family History of autoimmune diseases 
 +  * [[schirmer_test|Schirmer test]] (unanesthetized) ≤ 5mm in 5 minutes 
 +  * Ocular Surface Staining  
 +    * [[ocular_surface_staining_score|OSS > 3-5]] 
 +    * Conjunctival lissamine green staining
  
 +===== Diagnostic Criteria 2016 =====
 +<WRAP round box 80%>
 |Item|Weight/Score| |Item|Weight/Score|
 |Anti-SSA / Ro antibody positivity|3| |Anti-SSA / Ro antibody positivity|3|
-|Focal lymphocytic sialadenitis with a focus score of ≥ 1 foci / 4 mm²|1|+|Focal lymphocytic sialadenitis* with a focus score of ≥ 1 foci / 4 mm²|3|
 |Abnormal ocular staining score of ≥ 5 (or van Bijsterveld score of ≥ 4) |1| |Abnormal ocular staining score of ≥ 5 (or van Bijsterveld score of ≥ 4) |1|
 |Shirmer's test (no local anesthetic) result of ≤ 5mm / 5 minutes|1| |Shirmer's test (no local anesthetic) result of ≤ 5mm / 5 minutes|1|
 |Unstimulated salivary flow rate of ≤ 0.1 ml/minute|1|  |Unstimulated salivary flow rate of ≤ 0.1 ml/minute|1| 
-Source: {{ ::shiboski_-_2016_american_college_of_rheumatology_european_league_against_rheumatism.pdf |Shiboski et. al. 2016 American College of Rheumatology Classification Criteria for Primary Sjögren's Syndrome}}+*A histological feature defined by tightly-aggregated mononuclear cells adjacent to striated ducts
  
 +Source: {{ ::shiboski_-_2016_american_college_of_rheumatology_european_league_against_rheumatism.pdf |Shiboski et. al. 2016 American College of Rheumatology Classification Criteria for Primary Sjögren's Syndrome}}
 +</WRAP>
 {{tag>syndrome}} {{tag>syndrome}}