PMID- 7979575
OWN - NLM
STAT- MEDLINE
DCOM- 19941229
LR  - 20220321
IS  - 0003-4967 (Print)
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 53
IP  - 10
DP  - 1994 Oct
TI  - The European Community Study Group on diagnostic criteria for Sjogren's syndrome. 
      Sensitivity and specificity of tests for ocular and oral involvement in Sjogren's 
      syndrome.
PG  - 637-47
AB  - AIM: To establish a definitive set of diagnostic criteria in a multicentre 
      European study a selected number of oral and ocular tests were performed on a 
      large number of patients with Sjogrens Syndrome (SS) and controls. The diagnostic 
      accuracy of each test for patients with primary and secondary SS and for controls 
      at different ages, was studied. METHODS: Each centre received a clinical chart 
      describing the series of tests to be conducted. The tests included: 
      questionnaires for dry eye and dry mouth symptoms, Schirmer's-I-test (ScT), tear 
      fluid lactoferrin level (TFLL), break-up time (BUT) and rose Bengal score (RBS) 
      for the eye evaluation; unstimulated and stimulated whole saliva collection (UWSC 
      and SWSC), salivary gland scintigraphy (SGS), parotid sialography (PS) and minor 
      salivary gland biopsy (MSGB) for oral involvement. RESULTS: Data from 22 centres 
      and 11 countries was collected on a total of 447 patients with SS (246 with 
      primary SS and 201 with secondary SS) and 246 controls (of whom 113 had a 
      connective tissue disease without SS). Among the ocular symptoms, the feeling of 
      dry eye and 'sand in the eye' were the ones most commonly recorded in patients 
      with SS. Similarly, the feeling of dry mouth, appearing either spontaneously or 
      when the patient was eating or breathing, was the most frequent subjective oral 
      symptom. Among the ocular tests, ScT showed the best balance between sensitivity 
      and specificity (76.9% and 72.4% respectively), while RBS was the most specific 
      test (81.7%). ScT and RBS gave also sufficiently concordant results. TFLL and BUT 
      gave considerably less reliable results, which were not concordant with each 
      other or with the other ocular tests. The quantitative lacrimal tests ScT and 
      TFLL produced significantly different results in elderly controls, while RBS did 
      not. Abnormal results for all of the ocular tests were less marked and less 
      frequent in patients with secondary SS than in those with primary SS. The oral 
      tests (except SWSC) were generally more reliable than the ocular tests in 
      diagnosing SS. In particular, PS was the most specific diagnostic tools (100%), 
      while MSGB (where the presence of at least one inflammatory focus was considered 
      as indicative for the diagnosis) showed a good balance between sensitivity and 
      specificity (82.4% and 86.2%, respectively). The tests showed a good degree of 
      agreement, and, with the exception of UWSC, were not influenced by age. In the 
      oral, as in the ocular tests, abnormal results were less frequent and less marked 
      in patients with secondary SS. CONCLUSIONS: The results clearly show that ScT and 
      RBS (for the eye evaluation), and SGS, PS, MSGB and UWSC (for salivary gland 
      involvement) are the most reliable tests for the diagnosis of SS. The clinician 
      should be aware, however, that the test results may vary depending on the age of 
      the patient and the type of SS (primary or secondary).
FAU - Vitali, C
AU  - Vitali C
AD  - Clinical Immunology/Rheumatology Units, University of Pisa, Italy.
FAU - Moutsopoulos, H M
AU  - Moutsopoulos HM
FAU - Bombardieri, S
AU  - Bombardieri S
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - EC 3.4.21.- (Lactoferrin)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Dry Eye Syndromes/etiology
MH  - Eye Diseases/*diagnosis
MH  - Female
MH  - Humans
MH  - Lactoferrin/analysis
MH  - Male
MH  - Middle Aged
MH  - Mouth Diseases/*diagnosis
MH  - Parotid Gland/diagnostic imaging
MH  - Radiography
MH  - Radionuclide Imaging
MH  - Saliva/metabolism
MH  - Salivary Glands/diagnostic imaging
MH  - Sensation Disorders/etiology
MH  - Sensitivity and Specificity
MH  - Sjogren's Syndrome/complications/*diagnosis
MH  - Tears/metabolism
PMC - PMC1005429
EDAT- 1994/10/01 00:00
MHDA- 1994/10/01 00:01
PMCR- 1997/10/01
CRDT- 1994/10/01 00:00
PHST- 1994/10/01 00:00 [pubmed]
PHST- 1994/10/01 00:01 [medline]
PHST- 1994/10/01 00:00 [entrez]
PHST- 1997/10/01 00:00 [pmc-release]
AID - 10.1136/ard.53.10.637 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 1994 Oct;53(10):637-47. doi: 10.1136/ard.53.10.637.