Ergün Mustafa Çağrı, Yılmaz Okancan, Bilgen Hakan, Oltulu Pembe, Kılınç Fahriye, Tunç Recep
Department of Internal Medicine, Division of Rheumatology, Necmettin Erbakan University Meram Medicine Faculty, Konya, Türkiye.
Department of Pathology, Necmettin Erbakan University Meram Medicine Faculty, Konya, Türkiye.
Arch Rheumatol. 2024 Jul 2;39(3):404-410. doi: 10.46497/ArchRheumatol.2024.10410. eCollection 2024 Sep.
This study aimed to investigate the relationship between patients with and without extraglandular involvement in Sjögren's syndrome (SS) by analyzing ANA (antinuclear antibody) and ENA (extractable nuclear antigen) results and minor salivary gland pathology findings.
A total of 265 (245 females; 20 males; mean age: 50.4±12.4; range, 19 to 79 years) patients diagnosed with SS were included in the retrospective cohort study between March 1, 2011, and December 1, 2021. Detailed documentation was performed, capturing demographic characteristics, clinical information, laboratory findings, medication usage, and manifestations of the syndrome. The patients were divided into two groups, with (78 females; 8 males; mean age: 52.7±11.5; range, 22 to 78 years or without (167 females; 12 males; mean age: 49.3±12.8; range, 19 to 79 years extraglandular involvement.
The mean follow-up duration was 63.1±31.9 months. Extraganular involvement, including joint involvement, lung involvement, central nervous system involvement, hematological involvement, hepatitis, and lymphoma, was observed in 32.5% of the patients. Patients with extraglandular involvement required multiple medications, while those with only glandular involvement predominantly used hydroxychloroquine. The mean duration from SS diagnosis to extraglandular involvement was 15.2±27.8 months. The comparison between patients with and without extraglandular involvement revealed a significant association between higher focus scores (FS) and extraglandular manifestations. However, no significant differences were observed in terms of ANA positivity, ANA titers, or ENA positivity. Regression analysis indicated that age and FS were linked to systemic involvement.
This study highlights the importance of FS as a predictive indicator for extraglandular manifestations in SS. Advanced age was found to be associated with an increased likelihood of extraglandular involvement. Assessing FS and age can aid in predicting extraglandular manifestations.
本研究旨在通过分析抗核抗体（ANA）和可提取核抗原（ENA）结果以及小唾液腺病理检查结果，探讨干燥综合征（SS）患者有无腺外受累之间的关系。
在2011年3月1日至2021年12月1日期间，共有265例（245例女性；20例男性；平均年龄：50.4±12.4岁；范围19至79岁）被诊断为SS的患者纳入回顾性队列研究。进行了详细记录，包括人口统计学特征、临床信息、实验室检查结果、用药情况以及综合征的表现。患者被分为两组，一组有腺外受累（78例女性；8例男性；平均年龄：52.7±11.5岁；范围22至78岁），另一组无腺外受累（167例女性；12例男性；平均年龄：49.3±12.8岁；范围19至79岁）。
平均随访时间为63.1±31.9个月。32.5%的患者出现腺外受累，包括关节受累、肺部受累、中枢神经系统受累、血液系统受累、肝炎和淋巴瘤。有腺外受累的患者需要多种药物治疗，而仅腺体受累的患者主要使用羟氯喹。从SS诊断到腺外受累的平均时间为15.2±27.8个月。有腺外受累和无腺外受累患者的比较显示，较高的灶性评分（FS）与腺外表现之间存在显著关联，但在ANA阳性率、ANA滴度或ENA阳性率方面未观察到显著差异。回归分析表明，年龄和FS与全身受累有关。
本研究强调了FS作为SS腺外表现预测指标的重要性。发现高龄与腺外受累可能性增加有关。评估FS和年龄有助于预测腺外表现。
