[Evaluation of clinical symptoms and laboratory data as diagnostic criteria for Sjögren's syndrome].

In this study the authors evaluated the sensitivity, specificity and misclassification error rate of the following parameters: subjective xerophthalmia (questionnaire), positive Schirmer's I test less than or equal to 5 mm/5 min, positive rose-bengal staining on slit lamp examination, subjective xerostomia (questionnaire), abnormal stimulated parotid flow rate less than or equal to 0.5 ml/5 min and recurrent parotid gland enlargement. Thirty-two patients with primary SS (pSS), 40 patients with some of the criteria for pSS, 20 patients with SS in association with RA (sSS), 45 patients with RA and some of SS criteria and 29 RA patients without any clinical or histological manifestations of SS participated in this study. The minor salivary gland histopathology (focal lymphocytic infiltrates greater than or equal to 2+ (T. M. Tarpley et al., 1972) was taken as prerequisite for the diagnosis of SS and the absence of any clinical or serological manifestations of other autoimmune disease for the diagnosis of pSS. Based on this analysis the authors suggested that definite pSS can be diagnosed in the absence of any other autoimmune disease, positive labial biopsy and the presence of subjective xerostomia or parotid gland enlargement or positive rose-bengal staining, and definite sSS if a patient has RA, positive labial biopsy and subjective xerophthalmia or positive rose-bengal staining.