Sjögren's Syndrome

Sjogren's syndrome is a chronic inflammatory autoimmune disease that mainly involves the exocrine glands, also known as autoimmune exocrine disease. In addition to the decreased function of salivary glands and lacrimal glands, as well as dry mouth and eyes, other exocrine glands and other organs outside the glands are involved, then symptoms of multi-system damage appear. There are a variety of autoantibodies and hyperimmunoglobulinemia in the patient's serum. The disease is divided into two types: primary and secondary. It is a global disease, the prevalence age is 40-50 years old, and it is more common in women. However, the existing diagnostic criteria cannot cover the entire spectrum of Sjogren's syndrome, and the effect of identifying atypical clinical manifestations or early cases is limited. Therefore, many patients are not diagnosed and treated in time, and the deficiencies and challenges in the diagnosis and management of early Sjogren's syndrome need to be resolved urgently.

Diagnosis of Sjögren's Syndrome

The diagnosis methods of Sjogren's syndrome are as follows:

• Blood routine. Patients may show anemia, leukopenia, thrombocytopenia and rapid erythrocyte sedimentation rate.
• Autoantibody examination. This disease can cause a variety of abnormally elevated or positive autoantibodies. Patients have elevated anti-nuclear antibody titers, positive anti-SSA, positive anti-SSB, rheumatoid factor, anti-M3 antibody, and so on. Among them, anti-SSA and SSB antibodies are of great significance. The former is easier to detect in patients with this disease, while the positive of the latter is more specific to the disease.
• Immunoglobulin detection. The vast majority of patients have polyclonal hyperimmunoglobulinemia, and a small number of patients have macroglobulinemia or monoclonal hyperimmunoglobulinemia.
• Eye examination. The dryness of the eyes is measured by the Schirmer tear test.
• Saliva flow measurement. It refers to the total amount of unstimulated saliva of sublingual mouth floor in a certain period of time, which is a sensitive index for evaluating xerostomia.
• Imaging examination. Ultrasound, CT and MRI can evaluate the morphology and function of salivary glands.

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Reference

1. Retamozo S. P, et al. (2019). "Prognostic markers of lymphoma development in primary Sjögren syndrome." Lupus. 28.8: 923-936.