Journal
CLINICAL MEDICINE
Volume 14, Issue 2, Pages 157-164Publisher
ROY COLL PHYS LONDON EDITORIAL OFFICE
DOI: 10.7861/clinmedicine.14-2-157
Keywords
Sjogren's syndrome; long-term follow-up; autoimmune diseases; non-Hodgkin's lymphoma; neoplasia
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The objective of this study was to evaluate the 25-year outcome of patients with primary Sjogren's syndrome (pSS). One hundred and fifty-two patients diagnosed with pSS (American European classification criteria) were retrospectively and descriptively analysed (1986-2011). Of all 152 patients, 55.9% were alive, 18.4% had died and 25.7% discontinued follow-up (mostly due to old age). Malignancy affected 28.3% and non-Hodgkin's lymphoma (NHL) affected 10.5%. The adjusted risk for development of NHL was an odds ratio (OR) of 10.5(95% confidence interval [CI]: 3.05-36.42) in patients with vasculitis (p<0.001), and OR 3.4 (95% CI 1.05-11.2) in the presence of glandular complications (parotid swelling, lymphadenopathy) (p=0.041). Seventy-five patients (49.3%) developed other autoimmune diseases (autoimmune thyroid disease [15.8%], pulmonary fibrosis [7.2%] and vasculitis [10.5%]). Although the course of pSS is relatively benign, over 25 years patients experience more clinical complications than previously described. In addition, vasculitis and glandular manifestations were significant predictors for NHL.
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