Brito-Zeron et al identified prognostic factors for a patient with primary Sjogren's syndrome. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Barcelona in Spain.
Patient selection: primary Sjogren's syndrome
Risk factors for vasculitis:
(1) parotid scintigraphy Grade III or IV (severe involvement; parotid scintigraphy may not be readily available)
(2) low complement C4 (< 0.11 g/L)
Risk factors for development of B-cell lymphoma:
(1) low complement C3 (< 0.82 g/L)
Risk factors for worse survival:
(1) systemic involvement (one or more of: non-erosive arthritis, Raynaud's phenomenon, lung involvement, nephropathy, vasculitis, peripheral neuropathy or CNS involvement)
(2) vasculitis
(3) low complement C4 (< 0.11 g/L)
(4) cryoglobulinemia (cryocrit > 1%)
Prognostic factors for adverse outcome and survival:
(1) vasculitis
(2) parotid scintigraphy Grade III or IV (severe involvement)
(3) low complement C3 (< 0.82 g/L) and/or low complement C4 (< 0.11 g/L)
(4) cryoglobulinemia
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Number of Prognostic Factors
|
10-Year Survival
|
|
0
|
94%
|
|
1
|
88%
|
|
2 to 4
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68%
|
A patient with 2 or more prognostic factors may benefit from more aggressive management.
