Description

Homma et al reported the criteria for Sjogren's syndrome proposed by the Research Committee on Sjogren's syndrome of the Ministry of Health and Welfare of Japan in 1977. This can help identify patients with Sjogren's syndrome. The authors are from Keio University School of Medicine and the National Murayama Hospital in Tokyo.


 

Patient selection: overt dry symptoms

 

Definite Sjogren's Syndrome - 2 or more of the following:

(1) keratoconjunctivitis sicca of unknown etiology

(2) Histology of lacrimal or salivary glands shows 2 or more lesions with >= 50 mononuclear cells around an intralobular duct (focus score > 1).

(3) The sialogram shows diffuse nodular or globular shadows with a diameter more than 1 mm diffusely in lobules.

 

Possible Sjogren's Syndrome - 2 or more of the following:

(1) keratoconjunctivitis sicca of unknown etiology

(2) decreased salivary gland secretion

(3) recurrent or chronic salivary gland swelling of unknown etiology

 

Criteria for definite keratoconjunctivitis sicca - 1 or both of the following:

(1) positive Rose-Bengal test (2+ or more) and positive Schirmer's test (less than 10 mm in 5 minutes)

(2) positive Rose-Bengal test (2+ or more) and positive fluorescent dye test

 

Criteria for suspected keratoconjunctivitis sicca - 1 or both of the following:

(1) positive Rose-Bengal test (1+) and positive Schirmer's test (less than 10 mm in 5 minutes)

(2) positive Rose-Bengal test (1+) and positive fluorescent dye test

 

where:

• "Unknown etiology" implies that the patient does not have another autoimmune disease.

• While there is some overlap in the first criterion, the second and third in each group do not overlap. Situations could arise where only #2 or #3 of the definite group and one of the items of the possible group would be present. It would seem that these also should be included in the possible group.

• The criteria do not include serologic test results.

 


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