Document Detail


Evaluation of patients with dry eye for presence of underlying Sjögren syndrome.
MedLine Citation:
PMID:  19421051     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the rate of Sjögren 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%) had rheumatoid arthritis and 24 (10.9%) had primary Sjögren 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-Ro 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.
Authors:
Esen Karamursel Akpek; Alena Klimava; Jennifer E Thorne; Don Martin; Kaevalin Lekhanont; Ann Ostrovsky
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cornea     Volume:  28     ISSN:  1536-4798     ISO Abbreviation:  Cornea     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-26     Completed Date:  2009-09-08     Revised Date:  2010-09-24    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  493-7     Citation Subset:  IM    
Affiliation:
Ocular Surface Diseases and Dry Eye Clinic, Division of Cornea, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. esakpek@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Antinuclear / blood
Biopsy
Child
Cohort Studies
Female
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Retrospective Studies
Risk Factors
Salivary Glands / pathology
Sjogren's Syndrome / complications*,  diagnosis*,  etiology
Time Factors
Xerophthalmia / etiology*
Young Adult
Grant Support
ID/Acronym/Agency:
EY 13707/EY/NEI NIH HHS; K23 EY013707-05/EY/NEI NIH HHS
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/SS-A antibodies; 0/SS-B antibodies
Comments/Corrections
Comment In:
Cornea. 2010 Sep;29(9):1072; author reply 1073   [PMID:  20577085 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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