Application of classification criteria of Sjogren syndrome in patients with sicca symptoms: Real-world experience at a medical center

Chiu, Yu-Hsiang; Lee, Tony Szu Hsien; Chao, En; Chen, I-Feng; Liu, Feng‐Cheng; Chiu, Chung-Hsin; Hc, Chen; Chang, Deh‐Ming; Chu, Shi-Jye; Kuo, Shih-Ming; Lu, Chun–Chi

doi:10.1016/j.jfma.2019.06.012

Cited by 8 publications

(5 citation statements)

References 26 publications

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“…Currently, diagnosis of SS is based on established classification criteria: the 2002 AECG Classification Criteria, 2012 SICCA criteria, 2016 ACR/EULAR criteria [17,38,39]. The majority of rheumatologists in Taiwan during study period applied the 2002 AECG criteria for the diagnosis of SS [40]. A primary SS diagnosis requires symptoms that meet four of the six AECG criteria or three of the four objective diagnostic criteria.…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Sjögren’s Syndrome in Patients with Obsessive-Compulsive Disorder: A Nationwide Population-Based Cohort Study

Chang

Tseng

Leong

et al. 2021

IJERPH

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Obsessive-compulsive disorder (OCD) includes a wide range of symptoms and is often associated with comorbidities. Although psychiatric involvement may be an early manifestation of Sjögren’s syndrome (SS), only a few studies have demonstrated the relationship between OCD and SS. This is a nationwide cohort study identifying the risk of SS in OCD patients. We studied a longitudinal health insurance database for the period from 1999 to 2013. The study group was OCD patients with at least three outpatient visits or one hospitalization. The comparison cohort was matched by age and sex, as well as comorbidities. We calculated the risk of Sjögren’s syndrome using Cox proportional hazard regression models. We performed a propensity score match for confounders and effect modifiers between the two groups. The propensity score probability was estimated through logistic regression. Primary outcome was the incidental SS. A total of 1678 patients with OCD (49% women, mean age: 35.6 years) and 3356 controls were followed up, resulting in 13,077 and 25,856 person-years, respectively. The hazard ratio for developing SS was 3.31 (95% C.I.: 1.74–6.28) in patients with OCD, compared to those without OCD after adjusting for age, sex, and comorbidities. Furthermore, the risk of SS significantly increased over the 2-year follow-up period after OCD diagnosis. We concluded that risk of SS is significantly increased in patients with OCD compared to those without OCD. Clinically, Sjögren’s symptoms in OCD patients should be regularly assessed.

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Section: Discussionmentioning

confidence: 99%

Increased Risk of Sjögren’s Syndrome in Patients with Obsessive-Compulsive Disorder: A Nationwide Population-Based Cohort Study

Chang

Tseng

Leong

et al. 2021

IJERPH

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“…After comparing the gold standard data of surgical or pathological diagnosis, it was found that the index of magnetic resonance imaging in the diagnosis of placenta accreta was 74%, which was slightly higher than that of color Doppler diagnostic index of 60.5%; there was no significant difference in the diagnostic index between the two groups ( P > 0.05) [ 22 ]. The kappa value of magnetic resonance imaging was 0.739, and the kappa value of acoustic Doppler was 0.610, both > 0.4, which were consistent with the gold standard, as shown in Table 4 .…”

Section: Methodsmentioning

confidence: 99%

Application of Ultrasound Combined with Magnetic Resonance Imaging in the Diagnosis and Grading of Patients with Prenatal Placenta Accreta

2022

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In order to study the clinical application value of placenta accreta (PIA) diagnosis and grading, the authors propose a method based on ultrasound combined with magnetic resonance imaging in the diagnosis and grading of prenatal placenta accreta patients. This method is adopted in materials and methods: a retrospective analysis of hospital patients with high suspicion of placenta accreta by clinical or ultrasonography between October 2019 and October 2021, the imaging and clinical data of 312 patients who underwent placental MRI examination. The MRI imaging data of all patients were jointly analyzed, and the main observation indicators are as follows: (1) dark zone in the placenta, (2) disruption of the border of the myometrium, (3) disruption of the myometrium, (4) abnormal blood vessels in the placenta, (5) enlargement of the lower part of the uterus, and (6) local bulge of the bladder/or invasion of the adjacent tissues of the uterus. The results show the following: in MRI combined with ultrasonography ( P < 0.05 ), there was no statistical significance in the specificity and accuracy of MRI combined with ultrasound to diagnose PIA ( P > 0.05 ). The comparison of graded diagnostic accuracy showed that in ultrasound alone < MRI alone < MRI combined with ultrasound, the differences were statistically significant ( P < 0.05 ). Ultrasound combined with MRI in the diagnosis of placenta accreta is in good agreement with the clinical and surgical pathological results; MRI examination can be used as an important method for prenatal placenta accreta screening. MRI can classify placenta accreta to some extent.

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“…Interestingly, neither Schirmer's nor Saxon's tests were statistically significantly different between patient and control groups, pointing to low diagnostic performance in both detecting SS patients and differentiating non-specific sicca symptoms from SS-associated ones, as can be also seen by the results of the ROC analyses. The low specificity of tests such as Schirmer's has also been pointed out by Chiu et al in a single-center retrospective casecontrol study examining a large cohort (n = 505 patients) [36]. Moreover, van Nimwegen et al showed poor diagnostic accuracy in a study that had as an objective the validation of the actual ACR/EULAR classification criteria [37].…”

Section: Discussionmentioning

confidence: 87%

Diagnostic Value of Labial Minor Salivary Gland Biopsy: Histological Findings of a Large Sicca Cohort and Clinical Associations

Triantafyllias,

Bach,

Otto

et al. 2023

Diagnostics

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(1) Background: The aim of this study was to analyze labial minor salivary gland biopsy (MSGB) findings of a large sicca cohort and to examine their associations with Sjogren’s syndrome (SS)-associated laboratory markers, phenotypic characteristics and systemic manifestations. Moreover, we sought to explore the ability of MSGB to identify SS patients among subjects with pre-diagnosed fibromyalgia (FM). (2) Methods: Included were all patients of three rheumatology departments having undergone a diagnostic MSGB within 9 years. Next to the examination of histological and immunohistochemical findings, we focused on activity and chronicity parameters of the underlying disease, autoantibodies, presence of systemic and hematologic involvement, as well as chronic pain and SS comorbidities. (3) Results: Among the 678 included patients, 306 (45.1%) had a positive focus score (FS). The remaining patients (n = 372) served as control subjects. There were significant correlations between FS and hypergammaglobulinemia (p < 0.001), ANA and rheumatoid factor positivity (both; p < 0.001), a weak significant correlation with erythrocyte sedimentation rate (rho = 0.235; p < 0.001) and a negative correlation with nicotine use (p = 0.002). Within the primary SS subgroup, FS was associated significantly with glandular enlargement (p = 0.007) and systemic hematologic manifestations (p = 0.002). Next to FS, CD20 cell staining showed an excellent diagnostic performance in the diagnosis of SS by an area under the curve of 0.822 (95%CI 0.780–0.864; p < 0.001). Interestingly, 42.1% of all patients with fibromyalgia (FM) having received an MSGB could be diagnosed with SS. (4) Conclusion: By examining one of the largest cohorts in the literature, we could show that MSGB histological and immunohistochemical findings not only play a key role in the classification and diagnosis of SS but could also provide important information regarding SS phenotype and systemic manifestations. Furthermore, MSGB may help differentiate patients with FM from patients with subclinical SS who suffer primarily from chronic pain.

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Application of classification criteria of Sjogren syndrome in patients with sicca symptoms: Real-world experience at a medical center

Cited by 8 publications

References 26 publications

Increased Risk of Sjögren’s Syndrome in Patients with Obsessive-Compulsive Disorder: A Nationwide Population-Based Cohort Study

Increased Risk of Sjögren’s Syndrome in Patients with Obsessive-Compulsive Disorder: A Nationwide Population-Based Cohort Study

Application of Ultrasound Combined with Magnetic Resonance Imaging in the Diagnosis and Grading of Patients with Prenatal Placenta Accreta

Diagnostic Value of Labial Minor Salivary Gland Biopsy: Histological Findings of a Large Sicca Cohort and Clinical Associations

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