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Strides in Diagnosing, Treating Sjögren’s
“One interesting change is the prevalence of Sjögren’s,” said Frederick B. Vivino, MD, a rheumatologist at Penn Rheumatology Associates and the Sjögren’s Syndrome Center in Philadelphia. “Many experts consider it to be the second most common autoimmune rheumatic disease.” In his presentation, “Sjögren’s Syndrome: Comprehensive Diagnosis and Management,” he stressed that, “just like in lupus, you’re dealing with an entire spectrum of disease.” Dr. Vivino reviewed diagnosis of Sjögren’s, including unusual presentations of symptoms like inflammatory myositis, fever of unknown origin, chronic fatigue syndrome, elevated erythrocyte sedimentation rate, and leukocytoclastic vasculitis.
“Sicca symptoms may be minimal or nil,” warned Dr. Vivino. There may be a discrepancy between symptoms and results of objective tests of eye and mouth dryness. “The bottom line is that if you have a patient with symptoms that fit, you’re obligated to order tests for Sjögren’s.”
He stressed using the American-European criteria for earlier and better diagnosis of Sjögren’s syndrome. “These criteria are in use in nearly every children’s center in the world,” said Dr. Vivino. “They clearly represent an advance over what we had before.”