CLINICAL AND LABORATORY PROFILE OF PATIENTS WITH SJOGREN'S SYNDROME

Abstract

Background: Taking into consideration the significant morbidity associated with this disease, early diagnosis & treatment is imperative.

Objectives: To study the clinical & laboratory profile of patients with Sjogren’s Syndrome.

Participants: 50 SS patients, 29 patients with primary SS & 21 patients with secondary SS were studied.

Study Design: The hospital based Prospective-retrospective observational study.

Methods: Total 50 patients fulfilling the Amercian-European Consensus Group (AECG) 2002 classification criteria for Sjogren’s Syndrome were enrolled in the study. A thorough clinical examination, including subjective & objective quantifications of sicca symptoms was performed in all participants.

Results: out of 50 patients, 29 (58%) were pSS & 21 (42%) were sSS. The mean age was 35.4 ±11.41 years (range 20-60 years) & the majority of patients were females (96%). The most common clinical presentation was dry mouth (100% in both pSS & sSS) followed by dry eyes (97% in pSS & 95% in sSS). Raynaud’s phenomenon was seen in 7% of patients with pSS & 48% of patients with sSS (P<0.001). Sialometry was positive in 93% of patients with pSS & 95%  of patients with sSS; positive Schirmer’s was seen in 66% & 48% of patients with pSS & sSS, respectively. ANA was positive in 41% pSS patients & 76% patients of sSS; 79% of patients with pSS &76% patients with sSS had positive anti-SSA antibody;  while as 69% patients with pSS & 33% of patients with sSS had positive anti-SSB antibody. 23 patients in pSS  & 13 patients in sSS underwent labial salivary gland biopsy; out of those 65% patients in pSS & 92% in sSS reported positive results with Focus Score ≥1.

Conclusions: The study demonstrates the female preponderance of the disease, with sicca symptoms being most common presentation in both primary & secondary SS. Raynaud’s phenomenon seen more commonly in sSS than pSS. Positive histopathology with focus score of ≥1 seen in higher percentage of patients with secondary SS.

Implications: All females especially of reproductive age-group presenting with Sicca symptoms should be screened for Sjogren’s Syndrome & other extraglandular manifestations.