Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus
Abstract Background Diagnosis of SS is a complex task, as no symptom or test is unique to this syndrome. The American-European Consensus Group (AECG 2002) and the American-European classification criteria of 2016 (ACR/EULAR 2016) emerged through a search for consensus. This study aims to assess the...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Advances in Rheumatology |
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| Online Access: | https://doi.org/10.1186/s42358-022-00280-1 |
| _version_ | 1797863208200962048 |
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| author | Ana Paula Espíndula Gianordoli Rafaella Vila Real Barbosa Laguardia Maria Carmen F. S. Santos Fabiano Cade Jorge Amanda da Silva Salomão Larissa Carvalho Caser Isac Ribeiro Moulaz Érica Vieira Serrano Samira Tatiyama Miyamoto Ketty Lysie Libardi Lira Machado Valéria Valim |
| author_facet | Ana Paula Espíndula Gianordoli Rafaella Vila Real Barbosa Laguardia Maria Carmen F. S. Santos Fabiano Cade Jorge Amanda da Silva Salomão Larissa Carvalho Caser Isac Ribeiro Moulaz Érica Vieira Serrano Samira Tatiyama Miyamoto Ketty Lysie Libardi Lira Machado Valéria Valim |
| author_sort | Ana Paula Espíndula Gianordoli |
| collection | DOAJ |
| description | Abstract Background Diagnosis of SS is a complex task, as no symptom or test is unique to this syndrome. The American-European Consensus Group (AECG 2002) and the American-European classification criteria of 2016 (ACR/EULAR 2016) emerged through a search for consensus. This study aims to assess the prevalence of Sjögren’s Syndrome (SS) in patients with Systemic Lupus Erythematosus (SLE), according to AECG 2002 and ACR-EULAR 2016 classifications, as well as clinical and histopathological features in this overlap. To date, there is no study that has evaluated SS in SLE, using the two current criteria. Methods This cross-sectional study evaluated 237 SLE patients at the outpatient rheumatology clinic between 2016 and 2018. Patients were submitted to a dryness questionnaire, whole unstimulated salivary flow (WUSF), “Ocular Staining Score” (OSS), Schirmer’s test I (ST-I), and labial salivary gland biopsy (LSGB). Results After verifying inclusion and exclusion criteria, a total of 117 patients were evaluated, with predominance of females (94%) and mixed ethnicity (49.6%). The prevalence of SS was 23% according to AECG 2002 and 35% to ACR-EULAR 2016. Kappa agreement between AECG 2002 and ACR-EULAR 2016 were 0.7 (p < 0.0001). After logistic regression, predictors for SS were: anti/Ro (OR = 17.86, p < 0.05), focal lymphocytic sialadenitis (OR = 3.69, p < 0.05), OSS ≥ 5 (OR = 7.50, p < 0.05), ST I positive (OR = 2.67, p < 0.05), and WUSF ≤ 0.1 mL/min (OR = 4.13, p < 0.05). Conclusion The prevalence of SS in SLE was 23% (AECG 2002) and 35% (ACR-EULAR 2016). The presence of glandular dysfunction, focal lymphocytic sialadenitis, and anti/Ro were predictors of SS in SLE. The greatest advantage of the new ACR-EULAR 2016 criteria is to enable an early diagnosis and identify the overlapping of these two diseases. ACR-EULAR 2016 criteria is not yet validated for secondary SS and this study is a pioneer in investigating prevalence based on the new criteria. |
| first_indexed | 2024-04-09T22:31:51Z |
| format | Article |
| id | doaj.art-89ee8b1f7ae543b4ae7463550775bb19 |
| institution | Directory Open Access Journal |
| issn | 2523-3106 |
| language | English |
| last_indexed | 2024-04-09T22:31:51Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
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| series | Advances in Rheumatology |
| spelling | doaj.art-89ee8b1f7ae543b4ae7463550775bb192023-03-22T12:42:56ZengBMCAdvances in Rheumatology2523-31062023-03-016311810.1186/s42358-022-00280-1Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosusAna Paula Espíndula Gianordoli0Rafaella Vila Real Barbosa Laguardia1Maria Carmen F. S. Santos2Fabiano Cade Jorge3Amanda da Silva Salomão4Larissa Carvalho Caser5Isac Ribeiro Moulaz6Érica Vieira Serrano7Samira Tatiyama Miyamoto8Ketty Lysie Libardi Lira Machado9Valéria Valim10Rheumatology Division, University Hospital Cassiano Antônio Moraes of Federal University of Espírito Santo (HUCAM-UFES/EBSERH)Federal University of Espírito SantoPathology Department, Science Health Centre, University Hospital (HUCAM-UFES/EBSERH), Federal University of Espirito SantoFederal University of Espírito SantoFederal University of Espírito SantoFederal University of Espírito SantoFederal University of Espírito SantoRheumatology Division, University Hospital Cassiano Antônio Moraes of Federal University of Espírito Santo (HUCAM-UFES/EBSERH)Department of Physiotherapy, Federal University of Espírito SantoRheumatology Division, University Hospital Cassiano Antônio Moraes of Federal University of Espírito Santo (HUCAM-UFES/EBSERH)Rheumatology Division, University Hospital Cassiano Antônio Moraes of Federal University of Espírito Santo (HUCAM-UFES/EBSERH)Abstract Background Diagnosis of SS is a complex task, as no symptom or test is unique to this syndrome. The American-European Consensus Group (AECG 2002) and the American-European classification criteria of 2016 (ACR/EULAR 2016) emerged through a search for consensus. This study aims to assess the prevalence of Sjögren’s Syndrome (SS) in patients with Systemic Lupus Erythematosus (SLE), according to AECG 2002 and ACR-EULAR 2016 classifications, as well as clinical and histopathological features in this overlap. To date, there is no study that has evaluated SS in SLE, using the two current criteria. Methods This cross-sectional study evaluated 237 SLE patients at the outpatient rheumatology clinic between 2016 and 2018. Patients were submitted to a dryness questionnaire, whole unstimulated salivary flow (WUSF), “Ocular Staining Score” (OSS), Schirmer’s test I (ST-I), and labial salivary gland biopsy (LSGB). Results After verifying inclusion and exclusion criteria, a total of 117 patients were evaluated, with predominance of females (94%) and mixed ethnicity (49.6%). The prevalence of SS was 23% according to AECG 2002 and 35% to ACR-EULAR 2016. Kappa agreement between AECG 2002 and ACR-EULAR 2016 were 0.7 (p < 0.0001). After logistic regression, predictors for SS were: anti/Ro (OR = 17.86, p < 0.05), focal lymphocytic sialadenitis (OR = 3.69, p < 0.05), OSS ≥ 5 (OR = 7.50, p < 0.05), ST I positive (OR = 2.67, p < 0.05), and WUSF ≤ 0.1 mL/min (OR = 4.13, p < 0.05). Conclusion The prevalence of SS in SLE was 23% (AECG 2002) and 35% (ACR-EULAR 2016). The presence of glandular dysfunction, focal lymphocytic sialadenitis, and anti/Ro were predictors of SS in SLE. The greatest advantage of the new ACR-EULAR 2016 criteria is to enable an early diagnosis and identify the overlapping of these two diseases. ACR-EULAR 2016 criteria is not yet validated for secondary SS and this study is a pioneer in investigating prevalence based on the new criteria.https://doi.org/10.1186/s42358-022-00280-1Systemic lupus erythematosusSjögren's syndromeClassification criteriaACR-EULAR 2016PrevalenceLabial salivary gland biopsy |
| spellingShingle | Ana Paula Espíndula Gianordoli Rafaella Vila Real Barbosa Laguardia Maria Carmen F. S. Santos Fabiano Cade Jorge Amanda da Silva Salomão Larissa Carvalho Caser Isac Ribeiro Moulaz Érica Vieira Serrano Samira Tatiyama Miyamoto Ketty Lysie Libardi Lira Machado Valéria Valim Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus Advances in Rheumatology Systemic lupus erythematosus Sjögren's syndrome Classification criteria ACR-EULAR 2016 Prevalence Labial salivary gland biopsy |
| title | Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus |
| title_full | Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus |
| title_fullStr | Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus |
| title_full_unstemmed | Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus |
| title_short | Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus |
| title_sort | prevalence of sjogren s syndrome according to 2016 acr eular classification criteria in patients with systemic lupus erythematosus |
| topic | Systemic lupus erythematosus Sjögren's syndrome Classification criteria ACR-EULAR 2016 Prevalence Labial salivary gland biopsy |
| url | https://doi.org/10.1186/s42358-022-00280-1 |
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