Evaluation of patients with dry eye for presence of underlying Sjögren syndrome.
Evaluation of patients with dry eye for presence of underlying Sjögren syndrome.
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DOI：
10.1097/ico.0b013e31818d3846
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发表时间：
2009-06
期刊：
影响因子：
2.8
通讯作者：
Ostrovsky A
中科院分区：
文献类型：
--
作者：
Akpek EK;Klimava A;Thorne JE;Martin D;Lekhanont K;Ostrovsky A
目的：评估干眼综合征患者队列中干燥综合征(SS)的发生率。我们回顾了最初诊断为干眼综合征(ICD码375.15或370.33)的患者的病历。在两年内(2004年1月至2006年1月)到同一干眼中心就诊两次或以上的患者被考虑。对220例干眼综合征患者进行了检测。共有57名患者(25.9%)有潜在的风湿性疾病，25名患者(11.4%)患有类风湿性关节炎(RA)，24名患者(10.9%)患有原发性干燥综合征(PSS)。大多数类风湿性关节炎患者(96%)在发病时就已确诊。在所有原发SS患者中，只有33.3%(8/24)的患者在发病时被诊断为SS。50%(12/24)被诊断为初步评估的结果。仅66.6%(8/12)的患者SSA或SSB检测为阳性。三分之一(4/12)的患者仅ANA检测呈阳性，滴度为1/320，需要少量唾液腺活检才能确诊。另有16.7%(4/24)的患者最初血清学检查为阴性，最终接受了少量唾液腺活检，并被诊断为SS。原发SS在干眼症患者中似乎被低估了，应该作为诊断评估的重点。在相当大比例的SS患者中，可能需要进行微小的唾液腺活检才能做出明确的诊断。
To evaluate the rate of Sjögren’s syndrome (SS) in a cohort of patients with dry eye syndrome. Medical records of patients with a primary diagnosis of dry eye syndrome (ICD code 375.15 or 370.33) were reviewed retrospectively. Patients who had 2 or more visits to a single dry eye center, during a 2-year period (1/2004 to 1/2006) were considered. Two hundred and twenty patients with dry eye syndrome were identified. A total of 57 (25.9 %) patients had an underlying rheumatic condition; 25 patients (11.4%) had rheumatoid arthritis (RA) and 24 (10.9%) had primary Sjögren’s syndrome (PSS). Majority of the patients with RA (96%) carried the diagnosis at the time of presentation. Of all patients with primary SS, only 33.3% (8/24) carried diagnosis at the time of presentation. Fifty percent (12/24) were diagnosed as a result of the initial evaluation. Among those only 66.6% (8/12) tested SSA or SSB positive. One third (4/12) tested only ANA positive at a titer of <1/320, and required minor salivary gland biopsy for definitive diagnosis. Additional 16.7% (4/24), who were initially serologically negative, eventually underwent minor salivary gland biopsy and became diagnosed with SS. Primary SS appears to be underdiagnosed in dry eye patients and should be the focus of diagnostic evaluations. A minor salivary gland biopsy might be required for a definitive diagnosis in a significant proportion of the patients with SS.