Comparison of Lacrimal and Salivary Gland Involvement in Sjögren's Syndrome

Abstract

The rose bengal score remains the eye test of choice, as it has the highest specificity for SS. Hyperglobulinemia and especially positive serologic findings for SS-B may warrant close monitoring of the eyes, since these serum findings appear to relate to the severity of ocular surface damage. Parotid sialography and stimulated secretion of SM/SL saliva are more specific in diagnosing SS than unstimulated secretion of whole saliva.

Unstimulated whole saliva flow for diagnosis of primary Sjögren’s syndrome: time to revisit the threshold?

“…This does not concern patients presenting with a severe extraglandular involvement, in which MSGB and immunological assays should be performed even without subjective or objective The adapted ACR/EULAR 2016 score was adapted from the ACR/EULAR 2016 classification criteria by modifying the level of the UWS flow rate cutoff to give 1 point for this item: a patient presenting a UWS flow lower than or equal to our tested threshold obtained 1 point on the adapted score UWS unstimulated whole saliva, Se sensitivity, Sp specificity, PPV positive predictive value, NPV negative predictive value, YI Youden's index dryness. In line with previous studies, we found that Schirmer's test ≤ 5 mm/5 min had a high sensitivity (89.2%), while a UWS flow rate of ≤ 0.1 mL/min was substantially less sensitive (43.0%) [8][9][10][11][12]. So, we aimed at identifying UWS flow thresholds that can be adapted to age-and sex-related variations observed in healthy population to optimize the diagnostic performances of this frequently used test.…”

Prognostic factors for the clinical severity of keratoconjunctivitis sicca in patients with Sjögren's syndrome

“…Researchers have made repeated attempts to determine the relationship between prognostic factors and ocular manifestations in SS. Toker et al 3 found a significant correlation between tear anti-La/SSB concentrations and rose bengal staining scores, and Vissink et al 17 demonstrated a positive correlation between the presence of La/SSB autoantibody in serum and rose bengal staining scores, which corresponds well with our results. The present study shows that a significant elevation of Ro/SSA and La/SSB autoantibodies in the sera of moderate to severe KCS in SS.…”

Predictive role of tear protein expression in the early diagnosis of Sjögren’s syndrome

“…8,36 Both clinical tests and tear proteome analysis showed different trends in the two populations (SS and not-SS DE), at least for some of the analysed parameters in the present study. In particular, SS patients exhibited lower TFBUT values as compared with DE patients, in agreement with some authors 31,37 but not with others, 38,39 while Schirmer test was not significantly different in the two groups in agreement with our previous work 40 but in disagreement with others. 31,37,38,41 A more general agreement was reached for ocular surface staining, Jones test and clearance test, that were found to be worse in the SS group as compared with the not-SS DE, in agreement with others.…”

“…In particular, SS patients exhibited lower TFBUT values as compared with DE patients, in agreement with some authors 31,37 but not with others, 38,39 while Schirmer test was not significantly different in the two groups in agreement with our previous work 40 but in disagreement with others. 31,37,38,41 A more general agreement was reached for ocular surface staining, Jones test and clearance test, that were found to be worse in the SS group as compared with the not-SS DE, in agreement with others. [38][39][40][41][42][43] Similarly, a significant lower content was demonstrated for LYS-C, LACTO and LIPOC-1 in SS group compared with not-SS DE, while on the contrary, SS patients showed higher values of exudated ALB compared with not-SS DE patients, in agreement with previous studies.…”