Revised Japanese Criteria for Sjoegren's Syndrome (1999)

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  • シェーグレン症候群の画像診断　　シェーグレン症候群の改訂診断基準（１９９９）について

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Abstract

Japanese diagnostic criteria for Sjögren's syndrome (SS) was revised in 1999. The content of the revised criteria with referring oral examination is explained. The sensitivity and specificity for diagnosing SS and characteristics of the revised criteria is described. The revised criteria consists of 4 major items; histopathology, oral examination, ocular examination and serological examination. The diagnosis of SS can be made when the patients meets at least two of the above 4 items.<br>The first item consists of histopathology of biopsy specimen either from A) labial salivary glands or from B) lachrymal glands. The number of cells in periductal lymphoid cell infiltration shows over 50 can be regarded as a focus. When the focus score which is defined as the number of focus per 4mm2 tissue area shows 1 or more the histopathology can be regarded as positive. The second item, oral examination consists of A) sialography or B) sialometry and salivary scintigraphy. The positive cut-off level in sialographic findings was revised to Stage I by Rubin and Holt classification which means small punctuate shadows less than 1mm in diameter diffuse distributed in whole gland. Both positive findings are required in the reduction of sialometry proven by either chewing gum test (10ml per 10 minutes or less) or the Saxon test (2 grams per 2 minutes or less) and decreased function in salivary gland scintigraphy.<br>The third item is the ocular examination. A) consists of the combination of Schirmer test and the rose bengal test, and B) consists of the combination of Schirmer test and fluorescein staining test.<br>The forth item consists of either A) anti-Ro/SS-A antibody positive or B) anti-La/SS-B antibody positive by the serologic test.<br>The revised diagnostic criteria was proven to show high 96.0% in sensitivity, 90.5% in specificity, 94.5% in accuracy for diagnosing SS when the criteria was examined in 900 sample patients from country wide in the survey research performed by a Grant-in-Aids for Scientific Research supported by Japan Society for the Promotion of Science. The wide recognition and practical use of the revised criteria is desirable.

Journal

  • Shika Hoshasen

    Shika Hoshasen 44 (1), 31-37, 2004

    Japanese Society for Oral and Maxillofacial Radiology

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