How is Sjogren's syndrome diagnosed? Don't forget this check!

Sjogren syndrome (SS) is a chronic, systemic autoimmune disease
characterized by lymphocyte proliferation and progressive exocrine gland damage.
In China, the standardized diagnosis and treatment of SS lags behind other common rheumatic diseases, such as rheumatoid arthritis and systemic lupus erythematosus
.

The use of correct and scientific diagnostic examination methods can better understand the condition faster and give help to patients
.
In the process of clinical diagnosis, do not forget the examination of keratoconjunctivitis sicca sinica, which mainly has the following 4 indicators
.

One

• Operation procedure: in a quiet and dark light environment, the standard Schirmer filter paper is bent at the scale, gently placed into the temporal edge of the lower eyelid of the subject, the patient is instructed to close his eyes gently, retain the filter paper for 5min, take out the filter paper after 5min, and measure the length
  of the test strip being wetted.
  

• Interpretation of results: The positive standard was Schirmer ≤5mm/5min
  .
  

Two

• Operation procedure: 5~10μl of sodium fluorescein is instilled into the lower eyelid conjunctiva, and after 2min, a cobalt blue filter should be applied for inspection
  under a slit lamp with the eyepiece set to 10x magnification and illumination set to "high".
  Ask the patient to keep their eyes open naturally after blinking once, and observe the time
  from blinking to the appearance of the first dark spot in the cornea.
  Measure 3 times and record the average
  .
  

• Results interpretation: The positive standard was BUT≤10s
  .
  

Three

• Operation procedure: 0.
  5% sodium fluorescein is instilled into each eye, within 4~8min, and the corneal staining is observed and scored
  by using a slit lamp equipped with a cobalt blue filter.
  A drop of 1% Lismine green dye is placed in the unanesthetized eye, and after blinking a few times, the patient is instructed to observe and score
  10x magnification under a neutral density filter using a slit lamp within 2 minutes.
  Punctate epithelial injuries will be stained, counting the number of
  corneal and conjunctival staining "spots".
  

• Corneal staining: 0 points for no staining, 1~5 fluorescein staining points for 1 point, 2 points for 6~30 fluorescein staining points, and 3 points for > 30 fluorescein staining points
  .
  The following three conditions are additional scores: 1 or more coloring points of fusion in the cornea, including linear staining, +1 point; Staining spots appear in the area with a central diameter of 4 mm in the cornea, +1 point; If filamentous staining of the cornea, +1 points
  .
  The maximum possible score for each cornea is 6.
  
  

• Conjunctival staining: 0 is divided into no staining (less than 10 dot staining in each area), 1 is divided into a small number of scattered spot staining (the number of conjunctival staining points is 10~32), 2 is divided into more dot staining but not fused into pieces (the number of conjunctival staining points is 33~100, the area of fusion area is less than 4mm²), 3 is divided into flaky staining (the number of conjunctival staining points exceeds 100, Multiple fusions).
  
  The maximum possible score for conjunctival staining of each eye is 6 points
  .
  

• Results were interpreted: The total score of conjunctival staining in each eye was the sum of the scores of three regions (nasal conjunctiva, cornea, temporal conjunctiva), and the highest score per eye was 12 points, and the International Clinical Collaboration Group of Sjogren's Syndrome (SICCA) recommended that the OSS score of ≥3 in either eye be a positive result, supporting the diagnosis
  of dry eye.
  

Local symptoms of primary Sjogren syndrome

What medications are recommended for treatment?

Where can I see more diagnosis and treatment methods for common rheumatology diseases?

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