Reviews
Practical diagnostic tips for the Sjögren Clinic: pearls, myths and mistakes
P. Brito-Zerón1, S. Retamozo2, A. Flores-Chávez3, M. Akasbi4, A. Sisó-Almirall5, M. Ramos-Casals6
- Research and Innovation Group in Autoimmune Diseases, Sanitas Digital Hospital, Hospital-CIMA-Centre Mèdic Milenium Balmes Sanitas, Barcelona, and Grup de Recerca Consolidat en la Síndrome de Sjögren (GRESS), Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), Generalitat de Catalunya, Spain.
- Grup de recerca consolidat en la síndrome de Sjögren (GRESS), Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), Generalitat de Catalunya, Spain.
- Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain, and Consejo Nacional de Ciencia y Tecnología (CONACYT), México DF, México.
- Department of Internal Medicine, Hospital Infanta Leonor, Madrid, Spain.
- Primary Care Centre Les Corts, Consorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona; Primary Healthcare Transversal Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, and Department of Medicine, University of Barcelona, Spain.
- Grup de Recerca Consolidat en la Síndrome de Sjögren (GRESS), Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), Generalitat de Catalunya; Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, and Department of Medicine, University of Barcelona, Spain. mramos@clinic.cat
on behalf of the Sjögren Syndrome Study Group, GEAS-SEMI
CER15872
2022 Vol.40, N°12
PI 2413, PF 2427
Reviews
Free to view
(click on article PDF icon to read the article)
PMID: 36200947 [PubMed]
Received: 23/05/2022
Accepted : 02/08/2022
In Press: 05/10/2022
Published: 20/12/2022
Abstract
More than 90 years have passed since Hendrik Sjögren began to consider that behind the dryness that several of his patients presented, there could be a systemic disease potentially linked to abnormal immune responses. For many years, the disease was mostly considered a minor syndrome compared with other systemic autoimmune diseases such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and vasculitis, and advances in its understanding were slow and little recognised. The irruption of new technologies at the end of the 20th century rapidly promoted the development of international projects with a wide impact and diffusion. In the last 20 years, a significant improvement has been achieved in epidemiological determinants, pathogenic mechanisms, diagnostic accuracy, and a standardised therapeutic approach for patients with Sjögren’s syndrome (SS). These developments have provided the tools for an early diagnosis and personalised management for most patients. However, a significant number of early myths and ongoing controversies are still making the appropriate management of SS difficult in daily clinical practice. This review provides a selection of pearls, myths, and mistakes that may serve as practical diagnostic tips for the Sjögren Clinic in four specific scenarios: defining the appropriate epidemiological background, enabling the earliest diagnostic suspicion as possible, improving the systemic characterisation of the disease, and designing an optimal follow-up of patients.
