Clinical Analysis Of61Cases Of Primary Sjogren’s Syndrome

Objective:In order to have a better understanding of the clinical features of Sjogren’s syndrome, and thereafter to develop viable therapeutic options, we reviewed the medical records of patients with primary Sjogren’s syndrome (pSS) diagnosed in our hospital. Some clinical and laboratory parameters were collected and analysed.Methods:A retrospective medical record review was performed among61hospitalized patients of pSS during a6-year period (January2007to December2012) in Sir Run Run Shaw Hospital of Zhejiang University. The diagnosis was made according to pSS International Classification of diagnostic criteria revised in2002, including patients’ medical history, eye examination, salivary glands ECT, antinuclear antibody spectrum analysis, the pathological exam of salivary glands and so on. Data were collected from age of onset, duration of the first symptoms, laboratory workup, complications, treatment and follow-up. Statistical analysis were performed to determine the correlation of anti-ANA/SSA/SSB/ACA-positive and high level of RF with system involvement, serum immunoglobulins and complement levels. Results:In our patients, the average age of onset was53.36±12.42years old. It was more common in women. The first symptom was complex and diverse. Dry mouth or dry eyes addressed as chief complaint of patients was accounted for only42.60%, leading to a late diagnosis or misdiagnosis rate as high as56.25%. SSA/Ro52/SSB/ACA antibody and RF positive rates were as follows:85.25%,62.07%,40.98%,19.67%, and55.10%. Increased IgG was found, in about45.61%of patient. Broken up time (BUT) examination, salivary glands ECT, labial gland biopsy sensitivity were assumed to be important in the diagnosis of SS. Systemic involvement of pSS was mostly common in the lungs (57.38%) and blood (39.34%). The relationship between organ involvement and positive anti-ANA/SSA/SSB/ACA as well as high RF was not statistically significant (P>0.05), but some positive autoantibodies may indicate an increased risk of organ involvement.Conclusion:1) pSS is more common in perimenopausal women2) The first symptom of pSS is divergent and this may result in late diagnosis or misdiagnosis.3) SSA/SSB antibody is critically important in the diagnosis of pSS. BUT, salivary glands ECT, labial gland pathologic examination are also needed to be included in the diagnostic strategy of the disease. ACA/RF positive may be indicative of pSS.4) The most commonly involved organs or systems of pSS are the lungs and blood system Positive Ro52antibody and high level of RF might be relevant with complications5) The prognosis of pSS is generally favorable.