Epidemiology, laboratory and image profile of Sjögren’s syndrome

Abstract

Purpose : Sjögren syndrome (SS) is present worldwide, with unknown cause and cure. The present work describes a large series of SS patients observed in Brazil and compare the data among SS and non-SS (NSS) patients, investigated for causes of dry eye and dry mouth.

Methods : A spontaneous sample of individuals with dry eye and/or dry mouth, referred from January 2012 to November 2018, were evaluated and classified as Primary SS (SS1), Secondary SS (SS2) or NSS, based on the American European Consensus. The demographic, clinical and laboratory aspects were analyzed. Images were analyzed for volume, the signal intensity ratio of Lacrimal gland (LG) and vitreous (LG/V), the signal intensity ratio of the ipsilateral parotid gland to vitreous (PG/V) and apparent diffusion coefficient (ADC) of LG and PG (DWI sequence with b=1000 mm/s2), and trigeminal ganglion (TG) volume using the 3.0 Tesla Magnetic Resonance Scanner.

Results : From a total of 418 individuals, 323 (77.3%) completed the exams and were classified as SS or NSS (255 and 68, respectively, where 153 were SS1 and 102 were SS2). The estimated prevalence of SS in the region is one case per 10,000 inhabitants. The mean age is 52.8 ± 15.7 years old, and 93% are women. The sex ratio distribution and the frequency of dry eye symptoms (DES) and dry mouth symptoms (DMS) were similar among the groups (P>0.05). There were no differences in OSDI score, Schirmer’s test (ST), salivary flow or corneal fluorescein staining measures among the groups (P>0.05). Rheumatoid factor (RF) and Antinuclear antibody (ANA), SSa, SSb, gamma fraction, beta-2 microglobulin and lip biopsy focus score were more frequently altered in SS1 and SS2 compared to NSS patients (P<0.05). The TG volume was significantly smaller in the SS group (P=0.0003).

Conclusions : Our data indicate that SS is frequent and that clinical signs and symptoms are not sufficient to distinguish SS from other causes of dry eye and dry mouth. Laboratory exams and MRI are useful to early diagnosis of SS, allowing specific treatment and prevent further complications.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.