Vitali et al developed the Sjogren's Syndrome Disease Activity Index (SSDAI) 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) body temperature
(2) fatigue
(3) change in fatigue
(4) change in salivary gland swelling
(5) articular symptoms
(6) leukopenia or lymphopenia
(7) lymph node and/or splenic enlargement
(8) pleuropulmonary symptoms
(9) change in vasculitis
(10) active renal involvement
(11) peripheral neuropathy
|
Parameter |
Finding |
Points |
|---|---|---|
|
body temperature |
normal |
0 |
|
|
>= 38°C (fever) |
1 |
|
fatigue |
none or mild |
0 |
|
|
severe enough to affect normal activities |
1 |
|
change in fatigue |
none or no change |
0 |
|
|
new onset or worsening |
1 |
|
change in salivary gland swelling |
none or no change |
0 |
|
|
new onset or increased |
3 |
|
articular symptoms |
absent |
0 |
|
|
present |
2 |
|
leukopenia or lymphopenia |
neither |
0 |
|
|
WBC < 3,500 per µL OR lymphocyte count < 1,000 per µL |
1 |
|
lymphadenopathy or splenomegaly |
absent |
0 |
|
|
present |
2 |
|
pleuropulmonary symptoms |
absent |
0 |
|
|
present |
4 |
|
change in vasculitis |
none or no change |
0 |
|
|
new onset or worsening or flare-up with palpable purpura |
3 |
|
active renal involvement |
absent |
0 |
|
|
present |
2 |
|
peripheral neuropathy |
absent |
0 |
|
|
recent onset |
1 |
where:
• Pleural and/or pulmonary symptoms include one or more of the following: pleurisy, segmental pneumonia or interstitial pneumonia.
• Renal involvement includes one or more of the following: increased serum creatinine above the upper limit of normal, new or worsening proteinuria with > 500 mg/day, new or worsening nephritis.
• Peripheral neuropathy should be confirmed by nerve conduction studies. Worsening of the neuropathy is not listed as a criteria but could be a sign of activity.
• Fever and salivary gland swelling should not be due to infection or other cause.
• Articular symptoms include arthritis (with inflammatory pain in 1 or more joints) or evolving arthralgias (new onset or worsening)
total SSDAI =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• An SSDAI >= 5 is associated with active disease.
Performance:
• Using a cutoff >= 5 for active disease had a sensitivity of 87% and specificity of 88%.
Purpose: To evaluate a patient with Sjogren's syndrome for disease activity using the Sjogren's Syndrome Disease Activity Index (SSDAI) of Vitali et al.
Specialty: Immunology/Rheumatology
Objective: severity, prognosis, stage, disease progression
ICD-10: M35.0,
