Sjögren's syndrome classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Classification
- There is no established system for the classification of [disease name].
OR
- [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
- [Group1]
- [Group2]
- [Group3]
- [Group4]
OR
- [Disease name] may be classified into [large number > 6] subtypes based on:
- [Classification method 1]
- [Classification method 2]
- [Classification method 3]
- [Disease name] may be classified into several subtypes based on:
- [Classification method 1]
- [Classification method 2]
- [Classification method 3]
OR
- Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
OR
- If the staging system involves specific and characteristic findings and features:
- According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
- The staging of [malignancy name] is based on the [staging system].
OR
- There is no established system for the staging of [malignancy name].
I. Ocular symptoms: a positive response to at least one of the following questions:
1. Have you had daily, persistent, troublesome dry eyes for more than 3 months?
2. Do you have a recurrent sensation of sand or gravel in the eyes?
3. Do you use tear substitutes more than 3 times a day?
II. Oral symptoms: a positive response to at least one of the following questions:
1. Have you had a daily feeling of dry mouth for more than 3 months?
2. Have you had recurrently or persistently swollen salivary glands as an adult?
3. Do you frequently drink liquids to aid in swallowing dry food?
III. Ocular signs-that is, objective evidence of ocular involvement defined as a positive result for at least one of the following two tests:
1. Schirmer's test, performed without anaesthesia (≤5 mm in 5 minutes)
2. Rose bengal score or other ocular dye score (≥4 according to van Bijsterveld's scoring system)
IV. Histopathology: In minor salivary glands (obtained through normal-appearing mucosa) focal lymphocytic sialoadenitis, evaluated by an expert histopathologist, with a focus score ≥1, defined as a number of lymphocytic foci (which are adjacent to normal-appearing mucous acini and contain more than 50 lymphocytes) per 4 square mm of glandular tissue
V. Salivary gland involvement: objective evidence of salivary gland involvement defined by a positive result for at least one of the following diagnostic tests:
1. Unstimulated whole salivary flow (≤1.5 ml in 15 min)
2. Parotid sialography showing the presence of diffuse sialectasias (punctate, cavitary or destructive pattern), without evidence of obstruction in the major ducts
3. Salivary scintigraphy showing delayed uptake, reduced concentration and/or delayed excretion of tracer
VI. Autoantibodies: presence in the serum of the following autoantibodies:
1. Antibodies to Ro(SSA) or La(SSB) antigens, or both