Abstract
Over the past 25 years, several classification criteria sets have been proposed for primary Sjögren’s syndrome (pSS). In this chapter, we describe the different features of these criteria and summarize the debate that has arisen in the scientific community over this period. We devote particular attention to a critical analysis of the American and European consensus group criteria (AECG), which have achieved important consensus in the literature. Proposals for the future are also outlined.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Nikolov NP, Illei GG. Pathogenesis of Sjögren’s syndrome. Curr Opin Rheumatol. 2009;21(5):465–70.
Fietta P, Delsante G, Quaini F. Hematologic manifestations of connective autoimmune diseases. Clin Exp Rheumatol. 2009;27(1):140–54.
Voulgarelis M, Tzioufas AG, Moutsopoulos HM. Mortality in Sjögren’s syndrome. Clin Exp Rheumatol. 2008;26(5 Suppl 51):S66–71.
Theander E, Jacobsson LT. Relationship of Sjögren’s syndrome to other connective tissue and autoimmune disorders. Rheum Dis Clin North Am. 2008;34(4):935–47, viii–ix.
Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carson SE, et al. Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis. 2002;61:554–8.
Iorgulescu G. Saliva between normal and pathological. Important factors in determining systemic and oral health. J Med Life. 2009;2(3):303–7.
Kikuchi M, Inagaki T, Ogawa K, Banno S, Matsumoto Y, Ueda R, et al. Histopathological investigation of salivary glands in the asymptomatic elderly. Arch Gerontol Geriatr. 2004;38(2):131–8.
Manthorpe R, Oxholm P, Prause JU, Schiodt M. The Copenhagen criteria for Sjögren’s syndrome. Scand J Rheumatol. 1986;61:19–21.
Homma M, Tojo T, Akizuki M, Yamagata H. Criteria for Sjögren’s syndrome in Japan. Scand J Rheumatol. 1986;61:26–7.
Skopouli FN, Drosos AA, Papaioannou T, Moutsopoulos HM. Preliminary diagnostic criteria for Sjögren’s syndrome. Scand J Rheumatol. 1986;61:22–5.
Fox RI, Robinson CA, Curd JG, Kozin F, Howell FV. Sjögren’s syndrome. Proposed criteria for classification. Arthritis Rheum. 1986;29(5):577–85.
Daniels TE, Silverman S, Michalski JP, Greenspan JS, Sylvester RA, Talal N. The oral component of Sjögren’s syndrome. Oral Surg Oral Med Oral Pathol. 1975;39:875–85.
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The 1987 revised American association criteria for classification of rheumatoid arthritis. Arthritis Rheum. 1988;31:315–24.
Daniels TE. Labial salivary gland biopsy in Sjögren’s syndrome: assessment as a diagnostic criterion in 362 suspected cases. Arthritis Rheum. 1984;27:147–56.
Fox RI, Saito I. Criteria for diagnosis of Sjögren’s syndrome. Rheumatol Dis North Am. 1994;20(2):391–407.
Shah F, Rapini RP, Arnett FC, Warner NB, Smith CA. Association of labial salivary gland histopathology with clinical and serologic features of connective tissue diseases. Arthritis Rheum. 1990;33:1682–7.
Atkinson JC, Travis WD, Slocum L, Ebbs WL, Fox PC. Serum anti-SS-B/La and IgA rheumatoid factor are markers of salivary gland disease activity in primary Sjögren’s syndrome. Arthritis Rheum. 1992;35:1368–72.
Daniels TE, Witcher JP. Association of patterns of labial salivary gland inflammation with keratoconjunctivitis sicca. Analysis of 618 patients with suspected Sjögren’s syndrome. Arthritis Rheum. 1994;6:869–77.
Prause JU, Manthorpe R, Oxholm P, Schiødt M. Definition and criteria for Sjögren’s syndrome used by the contributors to the First International Seminar on Sjögren’s syndrome – 1986. Scand J Rheumatol Suppl. 1986;61:17–8.
Workshop on diagnostic criteria for Sjögren’s syndrome: I. Questionnaires for dry eye and dry mouth. II Manual of methods and procedures. Clin Exp Rheumatol. 1989;7:212–19.
Vitali C, Bombardieri S, Moutsopoulos HM, Balestrieri G, Bencivelli W, Bernstein RM, et al. Preliminary criteria for the classification of Sjögren’s syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum. 1993;36(3):340–7.
Vitali C, Bombardieri S, Moutsopoulos HM, Coll J, Gerli R, Hatron PY, et al. Assessment of the European classification criteria for Sjögren’s syndrome in a series of clinically defined cases: results of a prospective multicentre study. The European Study Group on Diagnostic Criteria for Sjögren’s Syndrome. Ann Rheum Dis. 1996;55(2):116–21.
Fox RI. Fifth international symposium on Sjögren’s syndrome. Arthritis Rheum. 1996;39(2):195–6.
Ramos-Casals M, Garcia Carrasco M, Cervera R, Rosas J, Trejo O, de la Red G, et al. Hepatitis C virus infection mimicking primary Sjögren’s syndrome. A clinical and immunologic description of 35 cases. Medicine (Baltimore). 2001;80:1–8.
Novljan MP, Rozman B, Jerse M, Rotar Z, Kveder T, Tomsic M. Comparison of the different classification criteria sets for primary Sjögren’s syndrome. Scand J Rheumatol. 2006;35:463–7.
Langegger C, Wenger M, Duftner C, Dejaco C, Baldissera I, Moncayo R, et al. Use of the European preliminary criteria, the Breiman classification tree and the American–European criteria for diagnosis of primary Sjögren’s Syndrome in daily practice: a retrospective analysis. Rheumatol Int. 2007;27(8):699–702.
Binard A, Devauchelle-Pensec V, Fautrel B, Jousse S, Youinou P, Saraux A. Epidemiology of Sjögren’s syndrome: where are we now? Clin Exp Rheumatol. 2007;25(1):1–4.
Birlik M, Akar S, Gurler O, Sari I, Birlik B, Sarioglu S, et al. Prevalence of primary Sjögren’s syndrome in Turkey: a population-based epidemiological study. Int J Clin Pract. 2009;63(6):954–61.
Haugen AJ, Peen E, Hultén B, Johannessen AC, Brun JG, Halse AK, et al. Estimation of the prevalence of primary Sjögren’s syndrome in two age-different community-based populations using two sets of classification criteria: the Hordaland Health Study. Scand J Rheumatol. 2008;37(1):30–4.
Kabasakal Y, Kitapcioglu G, Turk T, Oder G, Durusoy R, Mete N, et al. The prevalence of Sjögren’s syndrome in adult women. Scand J Rheumatol. 2006;35(5):379–83.
Bjerrum KB. Keratoconjunctivitis sicca and primary Sjögren’s syndrome in a Danish population aged 30–60 years. Acta Ophthalmol Scand. 1997;75:281–6.
Zhang NZ, Shi CS, Yao QP, Pan GX, Wang LL, Wen ZX, et al. Prevalence of primary Sjögren’s syndrome in China. J Rheumatol. 1995;22(4):659–61.
Alamanos Y, Tsifetaki N, Voulgari PV, Venetsanopoulo AI, Siozos C, Drosos AA. Epidemiology of primary Sjögren’s syndrome in north-west Greece, 1982–2003. Rheumatology. 2006;45:187–91.
Trontzas PI, Andrianakos AA. Sjögren’s syndrome: a population-based study of prevalence in Greece: The ESORDIG study. Ann Rheum Dis. 2005;64:1240–1.
Bowman SJ, Ibrahim GH, Holmes G, Hamburger J, Ainsworth JR. Estimating the prevalence among Caucasian women of primary Sjögren’s syndrome in two general practices in Birmingham, UK. Scand J Rheumatol. 2004;33:39–43.
Tomsic M, Logar D, Grmek M, Perkovic T, Kveder T. Prevalence of Sjögren’s syndrome in Slovenia. Rheumatology. 1999;38:164–70.
Thomas E, Hay EM, Hajeer A, Silman AJ. Sjögren’s syndrome: a community-based study of prevalence and impact. Br J Rheumatol. 1998;37:1069–76.
Dafni UG, Tzioufas AG, Staikos P, Skopouli FN, Moutsopoulos MH. Prevalence of primary Sjögren’s syndrome in a closed rural community. Ann Rheum Dis. 1997;56:521–5.
Jacobsson LT, Axell TE, Hansen BU, Henricsson VJ, Larsson A, Lieberkind K, et al. Dry eyes or mouth – an epidemiological study in Swedish adults, with special reference to primary Sjögren’s syndrome. J Autoimmun. 1989;2(4):521–7.
Brun JG, Madland TM, Gjesdal CB, Bertelsen LT. Sjögren’s syndrome in an out-patient clinic: classification of patients according to the preliminary European criteria and the proposed modified European criteria. Rheumatology. 2002;41(3):301–4.
Sánchez-Guerrero J, Pérez-Dosal MR, Cárdenas-Velázquez F, Pérez-Reguera A, Celis-Aguilar E, Soto-Rojas AE, et al. Prevalence of Sjögren’s syndrome in ambulatory patients according to the American-European Consensus Group criteria. Rheumatology. 2005;44(2):235–40.
Kassan SS, Mutsopoulos HM. Clinical manifestations and early diagnosis of Sjögren syndrome. Arch Intern Med. 2004;164:1275–84.
Ramos Casals M, Tzioufas AG, Font J. Primary Sjögren’s syndrome: new clinical and therapeutic concepts. Ann Rheum Dis. 2005;64:347–54.
Morbini P, Manzo A, Caporali R, Epis O, Villa C, Tinelli C, et al. Multilevel examination of minor salivary gland biopsy for Sjögren’s syndrome significantly improves diagnostic performance of AECG classification criteria. Arthritis Res Ther. 2005;7(2):R343–8.
Whitcher JP, Shiboski CH, Shiboski SC, Heidenreich AM, Kitagawa K, Zhang S, et al. A simplified quantitative method for assessing keratoconjunctivitis sicca from the Sjögren’s Syndrome International Registry. Am J Ophthalmol. 2010;149(3):405–15.
Daniels TE, Criswell LA, Shiboski C, Shiboski S, Lanfranchi H, Dong Y, et al. An early view of the international Sjögren’s syndrome registry. Arthritis Rheum. 2009;61(5):711–4.
Acknowledgments
We thank Miss Wendy Doherty and Miss Luisa Marconcini for their valuable contribution in reviewing the text.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag London Limited
About this chapter
Cite this chapter
Baldini, C., Talarico, R., Bombardieri, S. (2011). Classification Criteria. In: Ramos-Casals, M., Stone, J., Moutsopoulos, H. (eds) Sjögren’s Syndrome. Springer, London. https://doi.org/10.1007/978-0-85729-947-5_29
Download citation
DOI: https://doi.org/10.1007/978-0-85729-947-5_29
Published:
Publisher Name: Springer, London
Print ISBN: 978-0-85729-946-8
Online ISBN: 978-0-85729-947-5
eBook Packages: MedicineMedicine (R0)