Clinical follow up study of 87 patients with sicca symptoms (dryness of eyes or mouth, or both)
| Autor: | Hannu Uusitalo, Heikki Helin, M. Pertovaara, Amos Pasternack, Juhani Pukander, Ari Miettinen, Markku Korpela |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Anti-nuclear antibody Immunology Physical examination Gastroenterology Salivary Glands General Biochemistry Genetics and Molecular Biology Extended Reports Rheumatology Rheumatoid Factor Median follow-up Internal medicine Biopsy Humans Immunology and Allergy Medicine Rheumatoid factor Aged Aged 80 and over biology medicine.diagnostic_test business.industry Middle Aged Prognosis medicine.disease Connective tissue disease Immunoglobulin A stomatognathic diseases Sjogren's Syndrome Immunoglobulin M Antibodies Antinuclear Immunoglobulin G Rheumatoid arthritis Disease Progression biology.protein Female beta 2-Microglobulin business Biomarkers Follow-Up Studies |
| Zdroj: | Annals of the Rheumatic Diseases. 58:423-427 |
| ISSN: | 0003-4967 |
| Popis: | OBJECTIVE To assess the prognosis of patients with sicca symptoms and to identify the clinical and immunological factors that most sensitively predict the later development of primary Sjogren’s syndrome (SS) or other connective tissue diseases. METHODS Eighty seven patients (72 female, 15 male) with sicca symptoms were re-evaluated after a median follow up time of 11 years (range 8–17). The clinical examination included ophthalmological examination (Schirmer’s test, break up time and Rose-Bengal staining). Labial salivary gland biopsy was performed and histological findings graded according to the Chisholm-Mason scale. The immunoserological tests included determination of rheumatoid factor (RF), antinuclear antibodies (ANA), anti-extractable nuclear antigen-antibodies (ENA), serum immunoglobulins IgA, IgG, and IgM, and serum β 2 -microglobulin (β 2 m). RESULTS At follow up 31 patients (36%) fulfilled modified Californian criteria (salivary flow measurements were not performed and Chisholm-Mason grades 3–4 were regarded as diagnostic histological findings) for possible or definite SS. Likewise, a significant progression of the histological findings was observed. Labial salivary gland re-biopsy was performed in 42 patients with grade 0–2 findings at baseline, progression to grades 3–4 being observed in 21 (50%) at follow up. The patients who later developed SS were at baseline significantly older (mean (SD) 52 (9) v 44 (14) years, p⩽0.005) compared with those not fulfilling the SS criteria at follow up; they also had significantly higher serum β 2 m (p⩽0.0005) and IgG concentrations (p⩽0.005), and they had positive ANA more frequently (p⩽0.01). CONCLUSION These results suggest that high age, increased values of serum β 2 m, ANA positivity and increased concentrations of serum IgG, might be useful indicators for the subsequent development of SS in patients with sicca symptoms. The prognosis of patients with these symptoms was favourable, and the clinical course was benign even in the 36% of patients who developed SS. No cases of lymphoma were observed. |
| Databáze: | OpenAIRE |
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