期刊
CORNEA
卷 28, 期 5, 页码 493-497出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ICO.0b013e31818d3846
关键词
dry eye; laboratory work-up; Sjogren syndrome
资金
- NEI NIH HHS [EY 13707, K23 EY013707-05, K23 EY013707] Funding Source: Medline
Purpose: To evaluate the rate of Sjogren syndrome (SS) in a cohort of patients with dry eye syndrome. Methods: Medical records of patients with a primary diagnosis of dry eye syndrome (International Classification of Diseases [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 (January 2004 to January 2006) were considered. Results: Two hundred twenty patients with dry eye syndrome were identified. A total of 57 patients (25.9%) had an underlying rheumatic condition: 25 patients (11.4%) bad rheumatoid arthritis and 24 (10.9%) had primary Sjogren syndrome (PSS). Majority of the patients with rheumatoid arthritis (96%) carried the diagnosis at the time of presentation. Of all patients with PSS, only 33.3% (8/24) carried the 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 (anti-Po antibodies) or SSB (anti-La antibodies) positive. One third of patients (4/12) tested only antinuclear antibody 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. Conclusions: PSS seems to be underdiagnosed in patients with dry eye syndrome 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.
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