Primary Sjögren Syndrome: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 896

Special Issue Editor


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Guest Editor
Division of Clinical Immunology, Department of Internal Medicine, Faculty of General Medicine, University of Debrecen, Móricz Zsigmond krt. 22, HU-4032 Debrecen, Hungary
Interests: Sjögren’s syndrome; systemic autoimmune diseases; clinical immunology

Special Issue Information

Dear Colleagues,

In the past few years, many intriguing novelties in the field of Sjögren’s syndrome have emerged. Beyond its pathogenesis, wherein we are getting closer and closer to the understanding of the initial steps of the disease, both the diagnosis and comprehensive management of Sjögren’s syndrome have achieved revolutionary milestones.

Regarding diagnosis, we should make efforts towards less invasive modalities. While minor salivary gland biopsy is still a gold—although not obligatory—standard of the diagnostic pathway, future classifications should focus on the use of accurate biomarkers and preserve histology for prognostic measures. Given the relatively high prevalence among systemic autoimmune diseases, perhaps it is time to consider a validation of diagnostic criteria instead of classification criteria.

The management of Sjögren’s syndrome extends far beyond prescribing artificial tears and saliva and systemic disease-modifying drugs. Thanks to the well-educated patient society, we can make shared decisions, and, with the help of patient reported outcome measures and their easy use on mobile phone applications, patients and physicians are finally able to speak a common language regarding disease activity and disease burden. There are several promising new drug developments in the pipeline that will hopefully help patients to live a full life—not only free of systemic disease activity but free of devastating sicca symptoms as well.

These topics will be discussed throughout this Special Issue.

Dr. Antónia Szántó
Guest Editor

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Keywords

  • Sjögren’s syndrome
  • disease burden
  • biomarkers
  • comprehensive management

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Published Papers (1 paper)

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Research

11 pages, 1132 KiB  
Article
Polyarthritis in Sjögren’s Syndrome: Difficulties in Distinguishing Extraglandular Manifestation and Associated Rheumatoid Arthritis
by Zsófia Aradi, Gábor Nagy, Ildikó Fanny Horváth, Péter Antal-Szalmás and Antónia Szántó
Diagnostics 2024, 14(14), 1494; https://doi.org/10.3390/diagnostics14141494 - 11 Jul 2024
Viewed by 499
Abstract
Aim of the study was to investigate the demographic data and disease course characteristics of patients with Sjögren’s syndrome (SS) and inflammatory joint pain of various origins and to search for factors that might help with the distinction of polyarthritis as an extraglandular [...] Read more.
Aim of the study was to investigate the demographic data and disease course characteristics of patients with Sjögren’s syndrome (SS) and inflammatory joint pain of various origins and to search for factors that might help with the distinction of polyarthritis as an extraglandular manifestation and rheumatoid arthritis as an associated systemic autoimmune disorder. A total of 355 patients were retrospectively analyzed, 128 of whom served as controls (SS-C), while 159 had polyarthritis as an extraglandular symptom of Sjögren’s syndrome (SS-pa) and 68 were diagnosed as having associated rheumatoid arthritis (SS-RA). The patients without any inflammatory joint manifestations were significantly older than the SS-pa patients, while, for the SS-RA group, the difference was not significant. The onset of joint pain appeared significantly earlier in the SS-RA patients. Regarding either extraglandular manifestations or associated autoimmune disorders, there were significant differences between the controls and both SS-pa and SS-RA groups, while no significant difference was found between the SS-pa and SS-RA groups. Thus, laboratory and imaging methods should be used to differentiate between the two conditions, but laboratory biomarkers are even more important for early diagnosis. A ROC curve analysis showed an acceptable diagnostic accuracy in differentiating between SS-pa and SS-RA patients using a binary logistic regression model, where highly positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) values, kidney involvement, and anti-Ro/SS-A positivity were shown to significantly raise the odds of having RA, whereas anti-La/SS-B positivity seemed to have a protective role, since it significantly decreased the odds of having it. Further biomarkers are needed to better classify SS patient cohorts with inflammatory joint pain of different origins and, consequently, different management requirements. Full article
(This article belongs to the Special Issue Primary Sjögren Syndrome: Diagnosis and Management)
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