Faculty of medicine, Paris Cité Université, Paris, France.
Department of Rheumatology, Université Paris-Saclay, INSERM UMR1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicetre, France.
RMD Open. 2023 Oct;9(4). doi: 10.1136/rmdopen-2023-003291.
To describe primary Sjögren's disease (SjD) patients presenting no or low level of dryness and to compare them with SjD patients with oral or ocular dryness features.
All patients diagnosed with SjD according to AECG or ACR/EULAR criteria in our tertiary reference centre were included. Patients with high or low subjective symptoms or objective signs of dryness were compared.
Overall, 509 patients were included for the comparison of patients with high (n=456) or low (n=53) level of subjective dryness and 472 for the comparison of patients with (n=359) or without (n=113) high objective dryness. Compared with patients with subjective dryness, patients without high subjective dryness were significantly younger (median 49 (39-62) years vs 58 (47-67) years, p<0.01), diagnosed earlier (median time from first symptoms to diagnosis 2 (0.5-4.5) years vs 4 (1-9.25), p=0.0056), more frequently anti-SSA positive ((83% vs 64%, p=0.008) and had less focal sialadenitis in minor salivary gland biopsy (69% vs 83%, p=0.02).The patients without high level of objective dryness (n=113) were also younger (51 (41-60) vs 58 (47-67) years, p<0.001) and were more frequently anti-SSA positive (79% vs 63%, p=0.002).In both groups, no difference was observed regarding disease activity.
Among the patients with SjD, those without high subjective or objective dryness features had a younger profile, a faster diagnosis which may result from a more acute onset, were more frequently anti-SSA positive than patients with high dryness features.
描述原发性干燥综合征（SjD）患者中无或低干燥程度的患者，并将其与具有口腔或眼部干燥特征的 SjD 患者进行比较。
纳入在我们的三级参考中心根据 AECG 或 ACR/EULAR 标准诊断为 SjD 的所有患者。比较有高或低主观症状或客观干燥体征的患者。
总体而言，比较主观干燥程度高（n=456）和低（n=53）的患者时，共纳入 509 例患者，比较有（n=359）或无（n=113）高客观干燥的患者时，共纳入 472 例患者。与主观干燥的患者相比，无高主观干燥的患者年龄明显较小（中位数 49（39-62）岁比 58（47-67）岁，p<0.01），诊断时间更早（中位数从首发症状到诊断的时间为 2（0.5-4.5）年比 4（1-9.25）年，p=0.0056），抗-SSA 阳性率更高（83%比 64%，p=0.008），小唾液腺活检中局灶性涎腺炎较少（69%比 83%，p=0.02）。无高水平客观干燥的患者（n=113）也更年轻（51（41-60）岁比 58（47-67）岁，p<0.001），抗-SSA 阳性率更高（79%比 63%，p=0.002）。在这两组患者中，疾病活动度均无差异。
在 SjD 患者中，无高主观或客观干燥特征的患者年龄更小，诊断更快，这可能是由于发病更急，抗-SSA 阳性率高于有高干燥特征的患者。
