Vitali et al developed the Sjogren's Syndrome Disease Damage Index (SSDDI) to evaluate patient's with Sjogren's Syndrome. The author are from multiple institutions in Italy and the study was supported by the Italian Society of Rheumatology.
Parameters:
(1) impairment of salivary flow
(2) dental loss
(3) impairment of tear flow
(4) structural abnormalities in the eyes
(5) involvement of the central nervous system (CNS)
(6) peripheral and/or autonomic neuropathy (involvement of the peripheral nervous system, PNS)
(7) pleural and/or pulmonary damage
(8) renal damage
(9) lymphoproliferative disease
|
Parameter |
Finding |
Points |
|---|---|---|
|
impaired salivary flow |
normal to minimal decrease |
0 |
|
|
unstimulated saliva flow < 1.5 mL over 15 minutes |
1 |
|
dental loss |
none or few |
0 |
|
|
almost complete or complete |
1 |
|
impaired tear flow |
normal to minimal decrease |
0 |
|
|
Schirmer 1 test < 5 mm in 5 minutes |
1 |
|
structural damage to eyes |
absent |
0 |
|
|
cataracts, corneal ulcer, chronic blepharitis |
1 |
|
involvement of CNS |
absent |
0 |
|
|
long-standing, stable |
2 |
|
involvement of PNS |
absent |
0 |
|
|
present |
1 |
|
pleural or pulmonary damage |
absent |
0 |
|
|
present |
2 |
|
renal damage |
absent |
0 |
|
|
present |
2 |
|
lymphoproliferative disorder |
absent |
0 |
|
|
present |
5 |
where:
• Measurement of salivary and tear flow outlined in Clin Exp Rheumatol. 1989; 7: 213-219.
• Pleural and/or pulmonary damage includes one or more of the following: pleural fibrosis, pulmonary interstitial fibrosis, significant and irreversible impairment of pulmonary function.
• Renal damage includes one or more of the following: increased serum creatinine, decreased GFR, renal tubular acidosis, nephrocalcinosis
• Lymphoproliferative disease may include non-Hodgkin's lymphoma, multiple myeloma or Waldenstrom's macroglobulinemia.
total SSDDI =
= SUM(points for all 9 parameters)
Interpretation:
• minimum SSDDI: 0
• maximum SSDDI: 16
• The higher the score the greater the damage caused by Sjogren's syndrome.
Purpose: To evaluate a patient with Sjogren's Syndrome using the Sjogren's Syndrome Disease Damage Index (SSDDI) of Vitali et al.
Specialty: Immunology/Rheumatology
Objective: severity, prognosis, stage, disease progression
ICD-10: M35.0,
