Recommendations from the Brazilian society of rheumatology for the diagnosis of Sjögren's syndrome (Part I): glandular manifestations (systematic review).

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101734172 Publication Model: Electronic Cited Medium: Internet ISSN: 2523-3106 (Electronic) Linking ISSN: 25233106 NLM ISO Abbreviation: Adv Rheumatol Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BioMed Central, [2018]-
    • Subject Terms:
      Sjogren's Syndrome/*diagnosis; Brazil ; Consensus ; Delphi Technique ; Dentists ; Dry Eye Syndromes/diagnosis ; Dry Eye Syndromes/etiology ; Humans ; Magnetic Resonance Imaging ; Ophthalmologists ; Pathologists ; Positron-Emission Tomography ; Rheumatologists ; Rheumatology ; Salivary Gland Diseases/diagnosis ; Salivary Glands/diagnostic imaging ; Salivation ; Sjogren's Syndrome/complications ; Societies, Medical ; Ultrasonography ; Xerostomia/diagnosis ; Xerostomia/etiology
    • Abstract:
      Background: Primary Sjögren's syndrome (pSS) is a systemic immune-mediated disease whose main characteristic is exocrine gland inflammation and, subsequent reduction in tear and saliva production. A delayed diagnosis is common due to the nonspecific clinical manifestations of disease. The aim of the present study was to develop recommendations for the diagnosis of glandular manifestations of pSS based on evidence and expert opinion. We conducted a systematic literature review to retrieve the best evidence available on the accuracy of diagnostic tests for pSS. We also held two in-person meetings with experts (rheumatologists, pathologists, ophthalmologists and dentists) to establish their level of agreement using the Delphi method. Ultimately, we generated 18 recommendations that aim to facilitate the diagnosis of the glandular manifestations of pSS.
      Conclusion: The diagnosis of glandular manifestations of pSS is complex and multidisciplinary. It requires specific knowledge in the field of ophthalmology, immunology, pathology and imaging, making it compulsory for the rheumatologist to work with professionals from these different areas in order to improve accuracy and early diagnosis. Glandular dysfunction tests, ANA, RF, Anti-Ro, protein electrophoresis, urinalysis, blood count, C-Reactive protein, complement, testing for syphilis and viruses (HCV, HIV) and SGUS should be investigated when dryness or systemic manifestation are present. Minor salivary gland biopsy is recommended for all anti-Ro negative or incomplete criteria cases.
    • Contributed Indexing:
      Keywords: Diagnosis; Lacrimal apparatus diseases; Practice guideline; Salivary gland diseases; Sjogren’s syndrome; Xerophthalmia; Xerostomia
    • Publication Date:
      Date Created: 20191220 Date Completed: 20200831 Latest Revision: 20200831
    • Publication Date:
      20221213
    • Accession Number:
      10.1186/s42358-019-0102-8
    • Accession Number:
      31852541