Patient selection: presence of signs and symptoms suggestive of Sjogren’s Syndrome
Parameters:
(1) serologic testing (anti-SSA/Ro, anti-SSB/La, rheumatoid factor, ANA titer)
(2) lymphocytic sialadenitis focus score in a labial salivary gland biopsy
(3) keratoconjunctivitis sicca and ocular staining score (OSS)
Criteria 1 – one or more of the following:
(1) positive serum anti-SSA/Ro
(2) positive serum anti-SSB/La
(3) positive rheumatoid factor AND ANA titer >= 1:320
Criteria 2: focus score in labial salivary gland biopsy >= 1 focus per 4 square mm
Criteria 3 – all of the following:
(1) keratoconjunctivitis sicca
(2) ocular staining score 3 to 6
(3) exclusions:- any of the following: (a) person using daily eye drops for glaucoma, (b) history of corneal surgery in past 5 years, (c) history of cosmetic eyelid surgery in the past 5 years
Sjogren’s syndrome is diagnosed if at least 2 of the criteria are present. The diagnosis of primary Sjogren’s syndrome requires exclusion of certain conditions (see 22.18.10).
Performance:
• The sensitivity was 96% and specificity 83%.
