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1.
Inclusion Criteria: Those with at least one of the symptoms of dry eyes or dry mouth, that is, at least one of the following is positive:
2.
Exclusion Criteria: Patients with the following conditions should be excluded due to possible overlapping clinical manifestations or interference with diagnostic test results:
3.
Applicable to anyone who meets the above inclusion criteria and excludes the exclusion criteria, and the sum of the following 5 scores ≥ 4 is diagnosed as pSS:
For more guidelines for the diagnosis and treatment of common rheumatology diseases, go to the "Clinical Decision Assistant App"!
2016 American College of Rheumatology (ACR)/European Union Against Rheumatism (EULAR) diagnostic criteria for primary Sjogren syndrome (pSS):
1.
Inclusion Criteria: Those with at least one of the symptoms of dry eyes or dry mouth, that is, at least one of the following is positive:
feeling unbearably dry eyes every day for more than 3 months;
repeated gritty sensations in the eyes;
Artificial tears need to be used 3 times or more times a day;
Feeling dry mouth daily for more than 3 months;
Swallowing dry foods requires frequent water assistance
.
or suspected SS with at least one systematic positive in the Sjogren's syndrome (SS) Disease Activity Index (ESSDAI) questionnaire for EULAR
.
2.
Exclusion Criteria: Patients with the following conditions should be excluded due to possible overlapping clinical manifestations or interference with diagnostic test results:
history of radiation therapy to the head and neck;
Active hepatitis C virus infection;
AIDS;
Sarcoidosis;
Amyloidosis;
Graft-versus-host disease;
IgG4-related diseases
.
3.
Applicable to anyone who meets the above inclusion criteria and excludes the exclusion criteria, and the sum of the following 5 scores ≥ 4 is diagnosed as pSS:
(1) Lip gland focal lymphocyte infiltration, and focal index ≥ 1 foci/4mm2, which is 3 points;
(2) Positive serum anti-SSA antibody, 3 points;
(3) at least 5 for monocular corneal staining score (OSS) ≥ or 4 points for Van Bijsterveld score≥ which is 1;
(4) At least single tear secretion test (Schirmer test) ≤ 5mm/5min, 1 point;
(5) Unstimulated total saliva flow rate ≤0.
1ml/min (Navazesh and Kumar assay) is 1 point
.
Routine use of cholinergic drugs should be fully discontinued before the above (3), (4), (5) examinations
to assess dry mouth and eyes.
The criteria have a sensitivity of 96% and a specificity of 95% and are applicable
in both the validation analysis of diagnostic criteria and enrollment in clinical trials.
What are the diagnostic tests for primary Sjögren's syndrome?
What medications are recommended for primary Sjogren syndrome?
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